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Gómez G, Monge-Rojas R, Vargas-Quesada R, Previdelli AN, Quesada D, Kovalskys I, Herrera-Cuenca M, Cortes LY, García MCY, Liria-Domínguez R, Rigotti A, Fisberg RM, Ferrari G, Fisberg M, Brenes JC. Exploring the FAO Minimum Dietary Diversity Indicator as a Suitable Proxy of Micronutrient Adequacy in Men and Women Across Reproductive and Non-reproductive Ages in 8 Latin American Countries. Food Nutr Bull 2024:3795721241242920. [PMID: 38807356 DOI: 10.1177/03795721241242920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
BACKGROUND Women's Dietary Diversity Score (WDDS) is an indicator of dietary diversity, a key component of diet quality in women of reproductive age (WRA). Limited information is available regarding its applicability in other population groups. OBJECTIVE To examine the ability of the Minimum Dietary Diversity for Women (MDD-W) of 5-food groups cutoff to predict micronutrient adequacy in men and women 15 to 65 years old from 8 Latin American countries. METHODS We used a 24-hour recall from 9216 participants in the Latin American Study on Nutrition and Health (ELANS) to determine Dietary Diversity Score (DDS) based on the consumption of 10 food groups. The Mean Probability of Adequacy (MPA) was associated with DDS for the overall sample, for men, WRA, and women of nonreproductive age (WNRA). Sensitivity and specificity analyses were performed to determine if the 5-food groups cutoff point for MDD can be used to correctly identify men, WRA, and WNRA with adequate micronutrient adequacy (MPA ≥ 0.70). RESULTS We found a mean DDS of 4.78 ± 1.33 and an MPA of 0.64 ± 0.16, with 59% of participants showing a diverse diet (DDS ≥ 5). The 5-food groups-cutoff point showed a better balance between sensitivity and specificity predicting an MPA ≥0.70 in men, WRA, and WNRA. MPA was significantly associated with DDS in WRA and for men and WNRA, as well. CONCLUSION The 5-food group MDD, originally intended to be used in WRA, performed equally well in predicting MPA ≥0.70 in men, WRA, and WNRA, and can be used as a proxy of micronutrient adequacy in Latin American population.
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Affiliation(s)
| | - Rafael Monge-Rojas
- Instituto Costarricense de Investigación en Nutrición y Salud (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | - Rulamán Vargas-Quesada
- Instituto Costarricense de Investigación en Nutrición y Salud (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | | | | | - Irina Kovalskys
- Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
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Fisberg M, Duarte Batista L, Previdelli AN, Ferrari G, Fisberg RM. Exploring Diet and Nutrient Insufficiencies across Age Groups: Insights from a Population-Based Study of Brazilian Adults. Nutrients 2024; 16:750. [PMID: 38474878 DOI: 10.3390/nu16050750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
Assessing dietary inadequacies can contribute to understanding the nutritional vulnerabilities of a country. This study aimed to investigate nutrient intakes and micronutrient inadequacies in the Brazilian adult population, with an interest in different age subgroups. We conducted a cross-sectional study with 1812 individuals aged 19 to 65 years from a population-based study with a representative sample of Brazilian adults. Dietary intake was assessed by two 24 h food recalls, and the probabilities of inadequate intake were estimated using the Dietary Reference Intake targets. Adequate macronutrient intake was over 99% for proteins, 84.7% for carbohydrates, and 80.7% for total fats. There was a high probability of inadequacy (above 90%) for vitamins D and E, but vitamin D inadequacy was very similar between the sexes. In contrast, vitamin E was more likely to be inadequately consumed among women. A high probability of inadequacies (above 85%) of calcium and magnesium were found in the population, regardless of age group. Except for iron, the probability of an inadequacy of other minerals increased with age. The results showed a relevant proportion of nutrient inadequacies, with those most at risk being women and older individuals, helping with the better targeting and monitoring of public-health policies that address nutritional problems in the population.
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Affiliation(s)
- Mauro Fisberg
- Centro de Excelência em Nutrição e Dificuldades Alimentares (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setúbal, Hospital Infantil Sabará, São Paulo 01227-200, Brazil
- Department of Pediatrics, Federal University of São Paulo, São Paulo 04023-062, Brazil
| | - Lais Duarte Batista
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | | | - Gerson Ferrari
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia 7500912, Chile
| | - Regina Mara Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
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Villar M, García MCY, Ocampo MB, Gómez G. Intake and food sources of sodium in the population residing in urban areas of Ecuador: results from ELANS study. Glob Health Action 2023; 16:2156110. [PMID: 36601889 PMCID: PMC9828780 DOI: 10.1080/16549716.2022.2156110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND In 2021, WHO notes that globally, 32% of annual deaths worldwide are due to cardiovascular causes, which have been attributed to excessive sodium intake, and therefore recommends a reduction in salt intake to less than 5 g/day. Ecuador does not have data on sodium consumption in the population. Hence, this study sought to determine the association between sodium consumption and sociodemographic variables in subjects living in urban areas of Ecuador. OBJECTIVES Determine the main dietary sources of sodium in subjects living in urban areas of the Coast and Highlands of Ecuador, and the association between sodium intake and sociodemographic variables such as: sex, region, marital status, socio-economic and educational level of this population. METHODS Sodium intake was studied in 800 subjects of both sexes aged 15 to 65 years living in urban areas in Ecuador, originating from the Latin American Nutrition and Health Study (ELANS) between 2014 and 2015. Data were obtained through two 24-hour recalls, and were accessed according to sex, region, age, marital status, socio-economic and educational levels. RESULTS The mean sodium intake was 4900 mg/day (SD ± 1188.32 mg/day), and both sexes exceeded the recommendations. Adjusting for energy intake, sodium consumption is higher in participants aged 50-65 years, from low socio-economic status and with basic education level. A positive relationship was found between sodium and energy intake. Around 48% of the sodium sources included the spices, condiments and herbs group. Within this group, salt itself constitutes 99% of sodium sources. CONCLUSIONS The Ecuadorian population consumes more than double the sodium recommendations, which vary according to gender and age. The first source of sodium is salt itself, which is part of spices and condiments food group. This data is important to formulate public health policies and interventions in Ecuador, especially in the population at risk.
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Affiliation(s)
- Mónica Villar
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador,CONTACT Mónica Villar Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito17-1200-841, Ecuador
| | | | - María Belén Ocampo
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | - Georgina Gómez
- Department of Biochemistry, School of Medicine, Universidad de Costa Rica, San José, Costa Rica
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Monge-Rojas R, Vargas-Quesada R, Previdelli AN, Kovalskys I, Herrera-Cuenca M, Cortés LY, García MCY, Liria-Domínguez R, Rigotti A, Fisberg RM, Ferrari G, Fisberg M, Gómez G. A Landscape of Micronutrient Dietary Intake by 15- to 65-Years-Old Urban Population in 8 Latin American Countries: Results From the Latin American Study of Health and Nutrition. Food Nutr Bull 2023:3795721231215267. [PMID: 38112070 DOI: 10.1177/03795721231215267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
BACKGROUND Latin American countries have shifted from traditional diets rich in micronutrients to a Westernized diet rich in high energy-dense foods and low in micronutrients. OBJECTIVE This study aimed to determine the prevalence of adequate micronutrient intakes in urban populations of 8 Latin American countries. METHOD Micronutrient dietary intake data were collected from September 2014 to August 2015 from 9216 men and women aged 15.0 to 65.0 years living in urban populations of 8 Latin American countries. Dietary intake was collected using two 24-hour recalls on nonconsecutive days. Micronutrient adequacy of intake was calculated using the Estimated Average Requirement cut-off method. RESULTS In general terms, the prevalence of inadequate intake of thiamine, riboflavin, niacin, folate, cobalamin, iron, phosphorus, copper, and selenium ranged from 0.4% to 9.9%. In contrast, the prevalence of inadequacy of pyridoxine, zinc, vitamin C, and vitamin A ranged from 15.7% to 51.5%. The nutrients with a critical prevalence of inadequacy were magnesium (80.5%), calcium (85.7%), and vitamin D (98.2%). The highest prevalence of inadequate intakes was observed in the low educational level, participants with overweight/obesity, in men, and varies according to socioeconomic status. CONCLUSIONS There is an urgent need to define direct regional actions and strategies in Latin America aimed at improving micronutrient adequacy, either through staple food fortification programs, agronomic biofortification, or food policies that facilitate economic access to micronutrient-rich foods.
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Affiliation(s)
- Rafael Monge-Rojas
- Costa Rican Institute for Research and Education on Nutrition and Health (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | - Rulamán Vargas-Quesada
- Costa Rican Institute for Research and Education on Nutrition and Health (INCIENSA), Tres Ríos, Cartago, Costa Rica
| | | | - Irina Kovalskys
- Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Marianella Herrera-Cuenca
- Universidad Central de Venezuela, Caracas, Venezuela
- Framingham State University, Framingham, MA, USA
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Eguiguren-Jiménez L, Acevedo S, Andrade JM. Examining the Relationship between Dietary Intake, Socioeconomic Status, and Systolic Blood Pressure of Adults on Hemodialysis in Quito, Ecuador. Curr Dev Nutr 2023; 7:102047. [PMID: 38162996 PMCID: PMC10756962 DOI: 10.1016/j.cdnut.2023.102047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/07/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Background In Ecuador, the number of adults on hemodialysis (HD) continues to rise. Currently, the effect dietary habits and socioeconomic status (SES) have on blood pressure is not known for those on HD. Objectives The objectives of this study focused on adults on HD in Quito, Ecuador to 1) assess the relationship between dietary intake and SES; 2) compare dietary intake to the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines; and 3) explore the relationship between dietary intake and systolic blood pressure. Methods This cross-sectional study was conducted at the dialysis center within Eugenio Espejo Specialties Hospital in Quito, Ecuador between May and June 2022 among 50 adults on HD. Three 24-h recalls were used to determine average dietary intake and the 25-item Instituto Nacional de Estadística y Censos-Stratification of SES was used to determine SES. Electrolytes and 2 blood pressure readings were collected. Qualitative narrative data analysis was performed to identify themes using NVivo v12. T-tests of independence, simple, and multiple linear regressions using age and sex as confounders were conducted using R and a P < 0.05 was deemed as statistically significant. Results On an average, 76% of participants consumed <25 kcal/kg body weight energy and 64% consumed <1 g protein/kg body weight. Participants consumed less energy and protein compared with the KDOQI guidelines (P < 0.05). Positive relationships were observed with potassium and blood pressure (β = 0.020, P < 0.05) and SES with energy, protein, and phosphorus (P < 0.05). Themes that were identified as contributing to dietary intake were limited knowledge, lack of consistency with dietary information, and limited appetite. Conclusions Findings from this study indicate that the focus should be on improving energy and protein intake for this population.
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Affiliation(s)
- Lucia Eguiguren-Jiménez
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL, United States
| | - Sofia Acevedo
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL, United States
| | - Jeanette M Andrade
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL, United States
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Echeverría G, Samith B, von Schultzendorf A, Pinto V, Martínez X, Sara D, Calzada M, Pacheco J, Plaza G, Scott F, Romero J, Mateo C, Julio MV, Utreras-Mendoza Y, Binder MV, Gutiérrez F, Riquelme ME, Cuevas M, Willatt R, Sánchez O, Keilendt A, Butrón P, Jarufe A, Huete I, Tobar J, Martin S, Alfaro V, Olivos M, Pedrals N, Bitran M, Ávalos I, Ruini C, Ryff C, Pérez D, Berkowitz L, Rigotti A. Mediterranean diet and psychological well-being intervention to reverse metabolic syndrome in Chile (CHILEMED trial). Contemp Clin Trials Commun 2023; 35:101167. [PMID: 37538196 PMCID: PMC10393605 DOI: 10.1016/j.conctc.2023.101167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/06/2023] [Accepted: 06/18/2023] [Indexed: 08/05/2023] Open
Abstract
Psychosocial status and lifestyle are key risk factors of non-communicable diseases (NCDs), which, in turn, are main drivers of healthcare costs and morbimortality worldwide, including Chile. Mediterranean diet (MedDiet) is one of the healthiest dietary patterns under study. However, its impact on high-risk conditions, such as metabolic syndrome (MetS), and NCDs outside the Mediterranean Basin remains mostly unexplored. Even though Central Chile has an environment, food production, and culinary traditions comparable to those present in Mediterranean countries, few studies -some with significant methodological limitations- have evaluated the effect of MedDiet on health and/or disease in Chilean subjects. Importantly, a Mediterranean lifestyle is a modus vivendi that integrates physical health with mental and social well-being. Psychological well-being (PWB) is associated with healthy behaviors, positive health outcomes, and longevity, thereby emerging as a novel healthcare goal. We report here an ongoing randomized controlled clinical trial in Chilean patients with MetS seeking to test whether (1) a PWB theory-based intervention facilitates induction to and increases long-term adherence to a locally adapted MedDiet, and (2) a MedDiet intervention -implemented alone or combined with well-being promotion- is more effective at reversing MetS compared to individuals following a low-fat diet without psychological support. The CHILEan MEDiterranean (CHILEMED) diet intervention study is a 1-year trial including patients with MetS living in Chile. Participants will be assigned randomly by a computer-generated random number sequence to one of the three intervention arms: a) low-fat diet as control group, b) MedDiet alone, and c) MedDiet plus well-being support. Patients will be followed-up by individual and/or group online nutritional sessions or phone cal as well as 6- and 12-month in-person re-assessment of medical history, medication use, food intake, PWB, anthropometrics/physical exam, and blood collection for laboratory analysis. The primary outcome of the trial will be the effect of the MedDiet -with or without PWB intervention- on overall reversal of MetS compared to low-fat diet alone. Based on a statistical superiority trial, expected impact, and patient loss, the estimated study sample is 339 subjects (113 individuals per arm in 3 equal-sized groups). Currently, we have enrolled 179 patients, predominantly women, evenly distributed by age (group means ranging from 45.7 to 48,9 years-old), 3/4 are obese with almost all of them showing abdominal obesity, 70% are hypertensive, whereas <10% exhibit diabetes. If findings turn out as expected (e.g., MedDiet -with or without PWB intervention- is better than the low-fat diet for reversion of MetS at 1-year follow-up), CHILEMED will provide further beneficial evidence of the MedDiet on NCD risk conditions beyond the Mediterranean region.
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Affiliation(s)
- Guadalupe Echeverría
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Bárbara Samith
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Andrea von Schultzendorf
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Victoria Pinto
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
- Carrera de Nutrición y Dietética, Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Ximena Martínez
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Daniela Sara
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Mariana Calzada
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Josefina Pacheco
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Gianella Plaza
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Francesca Scott
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Javiera Romero
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Camila Mateo
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - María Verónica Julio
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Yildy Utreras-Mendoza
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - María Victoria Binder
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Florencia Gutiérrez
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - María Emilia Riquelme
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Margarita Cuevas
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Rosario Willatt
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Omayra Sánchez
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Aracelli Keilendt
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Patricia Butrón
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Alessandra Jarufe
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Isidora Huete
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Josefina Tobar
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Sofía Martin
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Valentina Alfaro
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Matilde Olivos
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Nuria Pedrals
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Marcela Bitran
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | | | - Chiara Ruini
- Department for Life Quality Studies, University of Bologna, Rimini, Italy
| | - Carol Ryff
- Institute on Aging and Department of Psychology, University of Wisconsin-Madison, Madison, WI, 53706-1611, USA
| | - Druso Pérez
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Loni Berkowitz
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
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7
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de Victo ER, Fisberg M, Solé D, Kovalskys I, Gómez G, Rigotti A, Cortes LY, Yépez-Garcia MC, Pareja R, Herrera-Cuenca M, Drenowatz C, Christofaro D, Araujo T, Silva D, Ferrari G. Joint Association between Sedentary Time and Moderate-to-Vigorous Physical Activity with Obesity Risk in Adults from Latin America. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085562. [PMID: 37107844 PMCID: PMC10138536 DOI: 10.3390/ijerph20085562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 05/11/2023]
Abstract
Recent studies have shown various relationships between physical activity and the incidence of obesity, but this study critically explored the association of sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) with obesity risk in adults from eight Latin American countries. ST and MVPA were assessed with accelerometers and stratified into 16 joint categories. Multivariate logistic regression models were used. The obesity risk indicators evaluated were body mass index (BMI), waist circumference (WC), and neck circumference (NC). Quartile 4 of ST and ≥300 min/week of MVPA was associated with lower odds of BMI compared to quartile 1 of ST and ≥300 min/week of MVPA. Quartile 1 of ST and 150-299 min/week of MVPA, quartile 1 of ST and 76-149 min/week MVPA, quartile 3 of ST and 76-149 min/week MVPA, and quartiles 1, 2, and 3 of ST with 0-74 min/week MVPA were associated with higher odds of high WC compared to quartile 1 of ST and ≥300 min/week of MVPA. Quartile 3 of ST and 150-299 min/week of MVPA, quartiles 1 and 3 of ST and 76-149 min/week of MVPA, and quartile 1 of ST and 0-74 min/week MVPA were associated with higher NC compared to quartile 1 of ST and ≥300 min/week of MVPA. This study suggests that achieving the MVPA recommendations will likely protect against obesity, regardless of ST.
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Affiliation(s)
- Eduardo Rossato de Victo
- Disciplina de Alergia, Imunologia Clínica e Reumatologia do Departamento de Pediatria da Universidade Federal de São Paulo, São Paulo 04023-062, Brazil
| | - Mauro Fisberg
- Centro de Excelência em Nutrição e Dificuldades Alimentares (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo 04023-061, Brazil
| | - Dirceu Solé
- Disciplina de Alergia, Imunologia Clínica e Reumatologia do Departamento de Pediatria da Universidade Federal de São Paulo, São Paulo 04023-062, Brazil
| | - Irina Kovalskys
- Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, Buenos Aires C1107, Argentina
| | - Georgina Gómez
- Department of Biochemistry, School of Medicine, Universidad de Costa Rica, San José 11501-2060, Costa Rica
| | - Attilio Rigotti
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica, Santiago 8330024, Chile
| | - Lilia Yadira Cortes
- Department of Nutrition and Biochemistry, Pontificia Universidad Javeriana, Bogotá 110231, Colombia
| | | | - Rossina Pareja
- Instituto de Investigación Nutricional, Lima 15026, Peru
| | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas 1053, Venezuela
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020 Linz, Austria
| | - Diego Christofaro
- Faculdade de Ciências e Tecnologia, Universidade Estadual Paulista, Presidente Prudente 01049-010, Brazil
| | - Timoteo Araujo
- Faculdades Metropolitanas Unidas, São Paulo 03021-000, Brazil
| | - Danilo Silva
- Department of Physical Education, Federal University of Sergipe, São Cristóvão 49100-000, Brazil
| | - Gerson Ferrari
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Providencia 7500912, Chile
- Correspondence:
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Nutritional Intake Differences in Combinations of Carbohydrate-Rich Foods in Pirapó, Republic of Paraguay. Nutrients 2023; 15:nu15051299. [PMID: 36904296 PMCID: PMC10004760 DOI: 10.3390/nu15051299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
A national strategy for obesity prevention has been promoted in Paraguay, reflecting the situation where half of adults and 23.4% of children (under 5 years old) are overweight. However, the detailed nutritional intake of the population has not yet been studied, especially in rural areas. Therefore, this study aimed to identify obesity-causing factors in Pirapó by analyzing the results from a food frequency questionnaire (FFQ) and one-day weighed food records (WFRs). From June to October 2015, 433 volunteers (200 males and 233 females) completed the FFQ with 36 items and one-day WFRs. Body mass index (BMI) positively correlated with the consumption of sandwiches, hamburgers, and bread and with age and diastolic blood pressure, although pizza and fried bread (pireca) had a negative correlation in males (p < 0.05). BMI positively correlated with systolic blood pressure, whereas it negatively correlated with the consumption of cassava and rice in females (p < 0.05). The FFQ revealed that fried food with wheat flour was consumed once a day. WFRs showed that 40% of meals consisted of two or more carbohydrate-rich dishes, significantly higher in energy, lipids, and sodium than those containing only one carbohydrate-rich dish. These results imply that less oily wheat dish consumption and healthy combinations of dishes should be considered for obesity prevention.
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Herrera-Cuenca M, Yépez García MC, Cortés Sanabria LY, Hernández P, Sifontes Y, Ramírez G, Vásquez M, Gómez G, Liria-Domínguez MR, Rigotti A, Fisberg M, Kovaslkys I, Landaeta-Jiménez M. Contribution of Proteins to the Latin American Diet: Results of the ELANS Study. Nutrients 2023; 15:nu15030669. [PMID: 36771376 PMCID: PMC9920156 DOI: 10.3390/nu15030669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 02/01/2023] Open
Abstract
Dietary protein intake is vital to life. Here we sought to characterize dietary sources of protein in eight Latin American countries. Survey data were collected for Estudio Latinoamericano de Nutrición y Salud (ELANS); participants were from Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela (n = 9218, 15-65 years old). The primary aim of this analysis was to quantify per-person daily protein consumption by country and sociodemographic factors. Secondary aims: to quantify proportional intake of proteins by source, amount and processing, and to determine the adequacy of protein/essential amino acid intake. Younger groups (adolescents 15-19 years, adults 20-33 years) had the highest intake of proteins; middle-aged adults (34-49 years) had a lower intake, and older adults (50-65 years) had a strikingly lower intake. Protein consumption was higher in men than women. Animal proteins comprised nearly 70% of total daily protein intake in Argentina and Venezuela, contrasting with <60% in Peru, Chile, and Costa Rica. Brazil and Venezuela showed the highest protein intake within the highest education level. The higher the socioeconomic level, the higher the protein intake, except for Argentina, Chile, and Peru. Proportional intake of animal- and plant-based protein generally reflected the food availability by country. This study presents a pre-pandemic regional baseline and offers a perspective for future studies of changes related to government policies, climate, and dietary practices.
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Affiliation(s)
- Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV), Caracas 1053, Venezuela
- Fundación Bengoa, Caracas 1053, Venezuela
- Correspondence: ; Tel.: +58-1-(404)-9967838
| | | | | | - Pablo Hernández
- Escuela de Nutrición y Dietética, Facultad de Medicina, Universidad Central de Venezuela, Caracas 1053, Venezuela
| | - Yaritza Sifontes
- Fundación Bengoa, Caracas 1053, Venezuela
- Escuela de Nutrición y Dietética, Facultad de Medicina, Universidad Central de Venezuela, Caracas 1053, Venezuela
| | - Guillermo Ramírez
- Área de Postgrado en Estadística, Facultad de Ciencias Económicas y Sociales, Universidad Central de Venezuela, Caracas 1053, Venezuela
| | - Maura Vásquez
- Área de Postgrado en Estadística, Facultad de Ciencias Económicas y Sociales, Universidad Central de Venezuela, Caracas 1053, Venezuela
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José 11501-2060, Costa Rica
| | | | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8330024, Chile
| | - Mauro Fisberg
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo 04023-061, Brazil
| | - Irina Kovaslkys
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires C1107 AAZ, Argentina
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Are the different cut-off points for sitting time associated with excess weight in adults? A population based study in Latin America. BMC Public Health 2023; 23:110. [PMID: 36647028 PMCID: PMC9841640 DOI: 10.1186/s12889-023-15029-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Excess weight is increasing worldwide, and in Latin America more than half of the population is excess weight. One of the reasons for this increase has been excessive sitting time. Still, it remains to be seen whether there is an excessive amount of that time in Latin American adults. This study aimed to associate different sitting time cut-off points with the excess weight. METHODS Data from the Latin American Study of Nutrition and Health (ELANS), a cross-sectional population-based survey conducted in eight Latin American countries, were used. The excess weight indicators used were body mass index, and waist and neck circumferences. Sitting time was obtained using questionnaires and categorized at different cut-off points. Differences between sitting time categories (< 4 or ≥ 4; < 6 or ≥ 6; and < 8 or ≥ 8 hours/day) and excess weight were obtained by Student's t test for independent samples and the association between sitting time categories and different indicators of excess weight were obtained by logistic regression. RESULTS The median of the sitting time was 420 min/day (IQR: 240-600). There were no significant differences between body mass index (kg/m2) and waist circumference (cm) with categories of sitting time. The mean values of neck circumference (cm) were significantly higher in ≥4, ≥6 and ≥ 8 hours/day than < 4, < 6, and < 8 hours/day of sitting time in the pooled sample. Some distinct differences by country were observed. There were significant differences among excess weight by body mass index (63.2% versus 60.8) with < 8 vs ≥8 hours/day of sitting time. The proportion of excess weight by neck circumference was higher in participants who reported ≥4, ≥6, and ≥ 8 hours/day compared to < 4, < 6, and < 8 hours/day of sitting time. Considering ≥8 hours/day of sitting time, higher odds of excess weight were found evaluated by body mass index (OR: 1.10; 95% CI: 1.01, 1.20) and neck circumference (OR: 1.13; CI 95%: 1.03, 1.24) overall. CONCLUSIONS Sitting time above 8 hours/day was associated with higher odds of excess weight, even though there were no differences in waist circumference between sitting time categories. TRIAL REGISTRATION Clinical Trials NCT02226627. (27/08/2014).
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Guevara-Ramírez P, Cadena-Ullauri S, Ruiz-Pozo VA, Tamayo-Trujillo R, Paz-Cruz E, Simancas-Racines D, Zambrano AK. Genetics, genomics, and diet interactions in obesity in the Latin American environment. Front Nutr 2022; 9:1063286. [PMID: 36532520 PMCID: PMC9751379 DOI: 10.3389/fnut.2022.1063286] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 08/25/2023] Open
Abstract
Obesity is a chronic disease characterized by abnormal or excessive fat accumulation that could impact an individual's health; moreover, the World Health Organization (WHO) has declared obesity a global epidemic since 1997. In Latin America, in 2016, reports indicated that 24.2% of the adult population was obese. The environmental factor or specific behaviors like dietary intake or physical activity have a vital role in the development of a condition like obesity, but the interaction of genes could contribute to that predisposition. Hence, it is vital to understand the relationship between genes and disease. Indeed, genetics in nutrition studies the genetic variations and their effect on dietary response; while genomics in nutrition studies the role of nutrients in gene expression. The present review represents a compendium of the dietary behaviors in the Latin American environment and the interactions of genes with their single nucleotide polymorphisms (SNPs) associated with obesity, including the risk allele frequencies in the Latin American population. Additionally, a bibliographical selection of several studies has been included; these studies examined the impact that dietary patterns in Latin American environments have on the expression of numerous genes involved in obesity-associated metabolic pathways.
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Affiliation(s)
- Patricia Guevara-Ramírez
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Santiago Cadena-Ullauri
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Viviana A. Ruiz-Pozo
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Rafael Tamayo-Trujillo
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Elius Paz-Cruz
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Daniel Simancas-Racines
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Ana Karina Zambrano
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
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Sales D, Matsudo V, Fisberg M, Drenowatz C, Marques A, Ferrari G. Perception of the Neighborhood Environment, Physical Activity by Domain and Sitting Time in Brazilian Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15744. [PMID: 36497825 PMCID: PMC9740320 DOI: 10.3390/ijerph192315744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
This study aimed to examine the association between the neighborhood environment and domain-specific physical activity and sitting time in Brazilian adults. This cross-sectional study included 1803 adults (53.7% women) from Brazil's five regions (North, Northeast, Midwest, Southeast and South). The perception of the environment was evaluated via a questionnaire. We considered seven indicators of the neighborhood environment: land use mix-diversity, land use mix-access, street connectivity, walking/cycling facilities, aesthetics, safety from traffic and safety from crime. Using the IPAQ, we evaluated physical activity (transport and leisure) and sitting time. Overall, land use mix-diversity (β = 3.22; 95% CI = 0.26, 6.19), land use mix-access (β = 2.27; 95% CI = 0.76, 3.79), and walking/cycling facilities (β = 2.42; 95% CI = 0.35, 4.49) were positively associated with leisure-time physical activity (min/week). On the other hand, only land use mix-diversity (β = 3.65; 95% CI = 0.63, 5.49) was positively associated with transport physical activity (min/week). No neighborhood environment indicator was associated with sitting time (min/day). Perception of the neighborhood environment was associated with physical activity (transport and leisure), while no significant associations occurred with sitting time among the five regions of Brazil. The neighborhood environment can be a viable component in the promotion of physical activity, but geographic diversity must be considered.
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Affiliation(s)
- Diego Sales
- Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS), São Caetano do Sul 09521-160, Brazil
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo 04023-061, Brazil
| | - Victor Matsudo
- Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul (CELAFISCS), São Caetano do Sul 09521-160, Brazil
| | - Mauro Fisberg
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo 04023-061, Brazil
- Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, Pädagogische Hochschule Oberösterreich, 4020 Linz, Austria
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisbon, Portugal
- ISAMB, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Gerson Ferrari
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia 7500912, Chile
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Physical activity and daily steps cut offs points for overweight/obesity prevention among eight Latin American countries. Sci Rep 2022; 12:18827. [PMID: 36335253 PMCID: PMC9637090 DOI: 10.1038/s41598-022-23586-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 11/02/2022] [Indexed: 11/07/2022] Open
Abstract
This study aims to establish cut-off points for the number of minutes of physical activity intensity and the number of daily steps that identify overweight/obesity in adolescents, adults, and older adults. This study examined data from 2737 participants. Physical activity intensity and the number of daily steps were assessed using GT3X+ ActiGraph model accelerometers. Body mass index, waist-to-height ratio, and waist-to-hip ratio were used as indicators of overweight/obesity. The cut-off points for moderate-to-vigorous physical activity for the prevention of overweight/obesity according to body mass index in women ranged from 15.1 to 30.2 min/day; in men, the values were from 15.4 to 33.8 min/day. The lowest cut-off point for daily steps was established in the adolescent group for women and men (7304 and 5162). The highest value in women was 11,412 (51-65 years) and 13,234 in men (18-30 years). Results from measurements different from BMI, show average cut-off points for moderate-to-vigorous physical activity and daily steps of 29.1/8348 and 43.5/10,456 according to waist-to-height ratio; and results of 29.3/11,900 and 44.3/11,056 according to the waist-to-hip ratio; in women and men respectively. A more specific recommendation of physical activity and daily steps adjusted by sex and age range is suggested to prevent overweight/obesity.
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Castillo-Paredes A, Iglésias B, Farías-Valenzuela C, Kovalskys I, Gómez G, Rigotti A, Cortés LY, García MCY, Pareja RG, Herrera-Cuenca M, Fisberg M, Drenowatz C, Ferrero-Hernández P, Ferrari G. Perceived Neighborhood Safety and Active Transportation in Adults from Eight Latin American Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12811. [PMID: 36232117 PMCID: PMC9566435 DOI: 10.3390/ijerph191912811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
Neighborhood built environment is associated with domain-specific physical activity. However, few studies with representative samples have examined the association between perceived neighborhood safety indicators and domain-specific active transportation in Latin America. This study aimed to examine the associations of perceived neighborhood safety with domain-specific active transportation in adults from eight Latin American countries. Data were obtained from the Latin American Study of Nutrition and Health (n = 8547, aged 18-65). Active transportation (walking and cycling) was assessed using the long form of the International Physical Activity Questionnaire. Specifically, traffic density and speed as well as street lightening, visibility of residents regarding pedestrians and bicyclists, traffic lights and crosswalks, safety of public spaces during the day and at night, crime rate during the day and at night were used to evaluate perceived neighborhood safety. Slow traffic speeds, unsafe public spaces during the day, and crime during the day were associated with ≥10 min/week vs. <10 min/week of walking. Furthermore, drivers exceeding the speed limit and crime rate during the day were associated with reporting ≥10 min/week vs. <10 min/week of cycling. These results indicate a stronger association of the perceived neighborhood safety with walking compared to cycling.
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Affiliation(s)
- Antonio Castillo-Paredes
- Grupo AFySE, Investigación en Actividad Física y Salud Escolar, Escuela de Pedagogía en Educación Física, Facultad de Educación, Universidad de Las Américas, Santiago 8370040, Chile
| | - Beatriz Iglésias
- Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisbon, Portugal
| | - Claudio Farías-Valenzuela
- Sciences of Physical Activity, Sports and Health School, University of Santiago of Chile (USACH), Santiago 9170022, Chile
| | - Irina Kovalskys
- Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, Buenos Aires C1107, Argentina
| | - Georgina Gómez
- Department of Biochemistry, School of Medicine, Universidad de Costa Rica, San José 11501-2060, Costa Rica
| | - Attilio Rigotti
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica, Santiago 8330024, Chile
| | - Lilia Yadira Cortés
- Department of Nutrition and Biochemistry, Pontificia Universidad Javeriana, Bogotá 110231, Colombia
| | | | | | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas 1053, Venezuela
| | - Mauro Fisberg
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo 04023-061, Brazil
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020 Linz, Austria
| | | | - Gerson Ferrari
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Santiago 7500912, Chile
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Roldán-Aguilar EE, Vergara-Ramos G, Jaramillo-Osorno AF. Investigaciones realizadas en Colombia relacionadas con actividad física y obesidad 2010-2020. REVISTA POLITÉCNICA 2022. [DOI: 10.33571/rpolitec.v18n36a5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introducción: La obesidad es un problema de salud pública mundial. La actividad física es una herramienta importante de promoción y prevención de este problema. Se desconoce las investigaciones realizadas en Colombia al respecto, lo cual es necesario para implementar políticas públicas eficientes. Objetivo: analizar las investigaciones colombianas encontradas en bases de datos científicas sobre la actividad física y obesidad. Metodología: revisión sistemática de artículos de investigación realizados en Colombia del año 2010 al 2020, en las bases de datos PubMed y SciELO. Resultados: de 87 artículos encontrados, 23 cumplieron los criterios de inclusión. El 91,3 % publicados en revistas indexadas internacionalmente. 69,5% estudios observacionales, 17,4% ensayos clínicos y 8,7% revisiones sistemáticas. Conclusiones: poca producción en Colombia. La mayoría en revistas indexadas, tuvieron diseño observacional y encontraron asociación entre poca actividad física con sobrepeso/obesidad. Alta prevalencia de sobrepeso/obesidad. Pocos autores fueron profesionales en el área del deporte y el entrenamiento.
Introduction: Obesity is a global public health problem. Physical activity and exercise are important tools for promoting and preventing. The research carried out in Colombia in this regard is unknown, which is necessary to implement efficient public policies. Objective: to analyze Colombian research found in scientific databases on physical activity or exercise in overweight and obesity. Methodology: literary review of research articles carried out in Colombia from 2010 to 2020, in the PubMed and SciELO databases. Results: Of 87 articles found, 23 met the inclusion criteria. 91.3% published in internationally indexed journals. 69.5% observational studies, 17.4% clinical trials and 8.7% systematic reviews. Conclusions: little production in Colombia. Most of the indexed journals had an observational design and found an association between little physical activity and overweight/obesity. High prevalence of overweight/obesity. Few authors were professionals in the area of training.
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Moving Together to Advance Physical Activity Research in Low- and Middle-Income Countries: The Case of Latin America. J Phys Act Health 2022; 19:589-591. [PMID: 35961642 DOI: 10.1123/jpah.2022-0374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 07/12/2022] [Indexed: 11/18/2022]
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Ferrari G, Drenowatz C, Kovalskys I, Gómez G, Rigotti A, Cortés LY, García MY, Pareja RG, Herrera-Cuenca M, Del'Arco AP, Peralta M, Marques A, Leme ACB, Sadarangani KP, Guzmán-Habinger J, Chaves JL, Fisberg M. Walking and cycling, as active transportation, and obesity factors in adolescents from eight countries. BMC Pediatr 2022; 22:510. [PMID: 36042429 PMCID: PMC9426250 DOI: 10.1186/s12887-022-03577-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence has shown that active transportation decreases obesity rates, but considering walking or cycling as separate modes could provide additional information on the health benefits in adolescents. This study aimed to examine the associations between walking and cycling as form active transportation and obesity indicators in Latin American adolescents. METHODS Population-based study with 671 adolescents (mean age: 15.9 [standard deviation: 0.8] years) from eight countries participating in the Latin American Study of Nutrition and Health/Estudio Latino Americano Nutrition y Salud (ELANS). Walking and cycling for active transportation were measured using the International Physical Activity Questionnaire long version. Body mass index, waist circumference, neck circumference, and relative fat mass were used as obesity indicators. Associations were estimated using logistic regression models for the pooled data adjusted for country, sex, age, socio-economic levels, race/ethnicity, leisure-time physical activity and energy intake. RESULTS Mean time spent walking and cycling was 22.6 (SD: 33.1) and 5.1 (SD: 24.1) min/day, respectively. The median values were 12.8 (IQR: 4.2; 25.7) and 0 (IQR: 0; 6.2) for walking and cycling. Participants reporting ≥ 10 min/week of walking or cycling for active transportation were 84.2% and 15.5%, respectively. Costa Rica (94.3% and 28.6%) showed the highest prevalence for walking and cycling, respectively, while Venezuela (68.3% and 2.4%) showed the lowest prevalence. There was no significant association between walking for active transportation and any obesity indicator. In the overall sample, cycling for ≥ 10 min/week was significantly associated with a lower likelihood of overweight/obesity based on BMI (OR: 0.86; 95%CI: 0.88; 0.94) and waist circumference (OR: 0.90; 95%CI: 0.83; 0.97) adjusted for country, sex, age, socio-economic level, race/ethnicity, leisure-time physical activity and energy intake compared to cycling for < 10 min/week. There were no significant associations between cycling for active transportation and neck circumference as well as relative fat mass. CONCLUSIONS Cycling for active transportation was negatively associated with obesity indicators, especially body mass index and waist circumference. Programs for promoting cycling for active transportation could be a feasible strategy to tackle the high obesity rates in adolescents in Latin America. TRIAL REGISTRATION ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014.
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Affiliation(s)
- Gerson Ferrari
- Sciences of Physical Activity, Sports and Health School, University of Santiago of Chile (USACH), Santiago, Chile. .,Faculty of Health Sciences, Universidad Autónoma de Chile, Av. Pedro de Valdivia 425, 7500912, Providencia, Santiago, Chile.
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020, Linz, Austria
| | - Irina Kovalskys
- Nutrition Career, Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, AAZ, C1107, Buenos Aires, Argentina
| | - Georgina Gómez
- Department of Biochemistry, School of Medicine, Universidad de Costa Rica, San José, 11501-2060, Costa Rica
| | - Attilio Rigotti
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica, 8330024, Santiago, Chile
| | - Lilia Yadira Cortés
- Department of Nutrition and Biochemistry, Pontificia Universidad Javeriana, 110231, Bogotá, Colombia
| | - Martha Yépez García
- College of Health Sciences, San Francisco de Quito University, Quito, Ecuador
| | | | - Marianella Herrera-Cuenca
- Center for Development Studies, Central University of Venezuela (CENDES/UCV) Bengoa Foundation, Caracas, Venezuela
| | - Ana Paula Del'Arco
- Pediatric Department, Escola Paulista de Medicina, Federal University of Sao Paulo, Brazil - UNIFESP, São Paulo, Brazil
| | - Miguel Peralta
- CIPER, Faculty of Human Kinetics, University of Lisbon, 1499-002 Cruz Quebrada, Lisbon, Portugal.,ISAMB, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Adilson Marques
- CIPER, Faculty of Human Kinetics, University of Lisbon, 1499-002 Cruz Quebrada, Lisbon, Portugal.,ISAMB, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Ana Carolina B Leme
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Kabir P Sadarangani
- School of Kinesiology, Faculty of Health and Dentistry, Universidad Diego Portales, 8370057, Santiago, Chile.,School of Kinesiology, Faculty of Dentistry and Rehabilitation Sciences, Universidad San Sebastián, Bío Bío, Chile
| | - Juan Guzmán-Habinger
- Sports Medicine and Physical Activity Specialty, Science Faculty, Universidad Mayor, Santiago, Chile
| | | | - Mauro Fisberg
- Pediatric Department, Escola Paulista de Medicina, Federal University of Sao Paulo, Brazil - UNIFESP, São Paulo, Brazil.,Pensi Institute, José Luiz Egydio Setúbal Foundation- Sabará Children's Hospital, São Paulo, Brazil
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de Quadros VP, Balcerzak A, Allemand P, de Sousa RF, Bevere T, Arsenault J, Deitchler M, Holmes BA. Global Trends in the Availability of Dietary Data in Low and Middle-Income Countries. Nutrients 2022; 14:nu14142987. [PMID: 35889943 PMCID: PMC9324857 DOI: 10.3390/nu14142987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/06/2022] [Accepted: 07/12/2022] [Indexed: 02/05/2023] Open
Abstract
Individual-level quantitative dietary data can provide suitably disaggregated information to identify the needs of all population sub-groups, which can in turn inform agricultural, nutrition, food safety, and environmental policies and programs. The purpose of this discussion paper is to provide an overview of dietary surveys conducted in low- and middle-income countries (LMICs) from 1980 to 2019, analyzing their key characteristics to understand the trends in dietary data collection across time. The present study analyzes the information gathered by the Food and Agriculture Organization of the United Nations/World Health Organization Global Individual Food consumption data Tool (FAO/WHO GIFT). FAO/WHO GIFT is a growing repository of individual-level dietary data and contains information about dietary surveys from around the world, collected through published survey results, literature reviews, and direct contact with data owners. The analysis indicates an important increase in the number of dietary surveys conducted in LMICs in the past four decades and a notable increase in the number of national dietary surveys. It is hoped that this trend continues, together with associated efforts to validate and standardize the dietary methods used. The regular implementation of dietary surveys in LMICs is key to support evidence-based policies for improved nutrition.
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Affiliation(s)
- Victoria Padula de Quadros
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
- Correspondence:
| | - Agnieszka Balcerzak
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
| | - Pauline Allemand
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
| | - Rita Ferreira de Sousa
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
| | - Teresa Bevere
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
| | - Joanne Arsenault
- Intake—Center for Dietary Assessment, FHI Solutions, Washington, DC 20009, USA; (J.A.); (M.D.)
| | - Megan Deitchler
- Intake—Center for Dietary Assessment, FHI Solutions, Washington, DC 20009, USA; (J.A.); (M.D.)
| | - Bridget Anna Holmes
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy; (A.B.); (P.A.); (R.F.d.S.); (T.B.); (B.A.H.)
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Murillo AG, Gómez G, Durán-Agüero S, Parra-Soto SL, Araneda J, Morales G, Ríos-Castillo I, Carpio-Arias V, Cavagnari BM, Nava-González EJ, Bejarano-Roncancio JJ, Núñez-Martínez B, Cordón-Arrivillaga K, Meza-Miranda ER, Mauricio-Alza S, Landaeta-Díaz L. Dietary Patterns and Dietary Recommendations Achievement From Latin American College Students During the COVID-19 Pandemic Lockdown. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.836299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study aimed to compare the diet quality of different dietary patterns among college students from Latin American countries, including vegetarians, vegans, and omnivores during the COVID-19 pandemic. A cross-sectional, observational, multicenter study was conducted including a non- probabilistic sample of university students from 10 countries. University students were invited to participate in the study through social network platforms. Participants were self-reported to have followed a specific dietary pattern; either the Prudent diet, Western diet, Ovo-dairy-vegetarian diet, Fish-vegetarian diet, Strict vegetarian diet (vegan) or other. The last three patterns (vegetarians and vegans) were grouped as following a plant-based diet. A self-assessment survey was used to evaluate healthy eating habits using a questionnaire with values between 1 (do not consume) and 5 (consume) for a total of 9–45 points (higher values represent better eating habits). Unhealthy habits were assessed with nine questions. A total of 4,809 students filled out the questionnaire, and the majority of them were females (73.7%). A high percentage have been in lockdown for more than 5 months and were in lockdown when the survey was released. 74.3% were self-reported to follow a prudent diet, while 11.4% reported following a western dietary pattern and 8.8% a plant-based diet. When compliance with healthy and unhealthy dietary habits was analyzed, although all groups had low compliance, the plant-based diet group (56.09 ± 6.11) performed better than the Western diet group (48.03 ± 5.99). The total diet quality score was significantly higher for plant-based diet followers, who also tended to better achieve the recommendations than omnivorous students, especially the ones following a western diet. These results present evidence that young adults such as college-aged students have unhealthy dietary habits. However, the ones who follow a plant-based diet such as vegetarians and vegans exhibit better scores and healthier dietary conducts.
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20
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Meeting 24-h movement guidelines and markers of adiposity in adults from eight Latin America countries: the ELANS study. Sci Rep 2022; 12:11382. [PMID: 35790777 PMCID: PMC9256603 DOI: 10.1038/s41598-022-15504-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 06/24/2022] [Indexed: 11/08/2022] Open
Abstract
This study aimed to compare compliance with 24-h movement guidelines across countries and examine the associations with markers of adiposity in adults from eight Latin American countries. The sample consisted of 2338 adults aged 18-65 years. Moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) data were objectively measured using accelerometers. Sleep duration was self-reported using a daily log. Body mass index and waist circumference were assessed as markers of adiposity. Meeting the 24-h movement guidelines was defined as ≥ 150 min/week of MVPA; ≤ 8 h/day of SB; and between 7 and 9 h/day of sleep. The number of guidelines being met was 0.90 (95% CI 0.86, 0.93) with higher value in men than women. We found differences between countries. Meeting two and three movement guidelines was associated with overweight/obesity (OR: 0.75, 95% CI 0.58, 0.97 and OR: 0.69, 95% CI 0.51, 0.85, respectively) and high waist circumference (OR: 0.74, 95% CI 0.56, 0.97 and OR: 0.77, 95% CI 0.62, 0.96). Meeting MVPA and SB recommendations were related to reduced adiposity markers but only in men. Future research is needed to gain insights into the directionality of the associations between 24-h movement guidelines compliance and markers of adiposity but also the mechanisms underlying explaining differences between men and women.
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21
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Ferrari G, Farías-Valenzuela C, Guzmán-Habinger J, Drenowatz C, Marques A, Kovalskys I, Gómez G, Rigotti A, Cortés LY, Yépez García MC, Pareja RG, Herrera-Cuenca M, Marconcin P, Chávez JL, Fisberg M. Relationship between socio-demographic correlates and human development index with physical activity and sedentary time in a cross-sectional multicenter study. BMC Public Health 2022; 22:669. [PMID: 35387627 PMCID: PMC8988325 DOI: 10.1186/s12889-022-13117-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/30/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Socio-demographic correlates and human development index (HDI) are associated with self-reported physical activity, but only a few studies have focused on device-measured physical activity and sedentary time in Latin America. We examined the relationship between socio-demographic correlates and HDI with physical activity and sedentary time in a cross-sectional study. METHODS We based our analyses on 2522 (53.1% women; 18-65 years [mean age 38.3 years]) adults drawn from the eight Latin America countries. Physical activity (light, moderate, vigorous, and moderate-to-vigorous intensity and steps) and sedentary time were assessed using Actigraph GT3X + accelerometers. Sex, age, and race/ethnicity were self-reported. The HDI country information was obtained from the United Nations Development Program. RESULTS For the age, ethnicity, vigorous physical activity and steps/day, there were significant differences between high and very high HDI countries. Women and younger age presented lower sedentary time than men and older. In moderate-to-vigorous physical activity, we found lower duration in women (-13.4 min/week), younger age (-0.1 min/week), and white/caucasian (-2.7 min/week) than men, older ages and mixed ethnicity. Women (-1266.5 steps/week) and very high HDI (-847.3 steps/week) presented lower steps than men and high HDI. Black (2853.9 steps/week), other (1785.4 steps/week), and white/caucasian ethnicity (660.6 steps/week) showed higher steps than mixed ethnicity. CONCLUSIONS Different socio-demographic correlates are associated with physical activity intensity; however, HDI is associated with vigorous physical activity and steps in the Latin American region, which can in turn guide policies to promote physical activity in the region. TRIAL REGISTRATION ClinicalTrials.Gov NCT02226627 . Retrospectively registered on August 27, 2014.
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Affiliation(s)
- Gerson Ferrari
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Chile, Las Sophoras 175, Estación Central, Santiago, Chile. .,Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile.
| | | | - Juan Guzmán-Habinger
- Facultad de Ciencias, Universidad Mayor, Santiago, Chile.,Facultad de Ciencias, Especialidad medicina del deporte y la actividad física, Universidad Mayor, Santiago, Chile
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, Linz, Austria
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal.,ISAMB, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Irina Kovalskys
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Lilia Yadira Cortés
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | | | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas, Venezuela
| | - Priscila Marconcin
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | | | - Mauro Fisberg
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo, Brazil.,Departamento de Pediatria da Universidade Federal de São Paulo, São Paulo, Brazil
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22
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Ferrari G, Werneck AO, Silva DR, Kovalskys I, Gómez G, Rigotti A, Cortés LY, García MCY, Liria-Domínguez MR, Herrera-Cuenca M, Pratt M, Marques A, Van Dyck D, Leme ACB, Fisberg M. Perceived Urban Environment Attributes and Device-Measured Physical Activity in Latin America: An 8-Nation Study. Am J Prev Med 2022; 62:635-645. [PMID: 34810040 DOI: 10.1016/j.amepre.2021.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 07/21/2021] [Accepted: 09/13/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Attributes of the neighborhood-built environment are associated with self-reported physical activity, but only a few studies have concentrated on device-measured physical activity in Latin America. This study examines the associations of perceived neighborhood-built environment attributes, device-measured sedentary time, and light-intensity and moderate-to-vigorous physical activity in adults from 8 Latin American countries. METHODS Data from Estudio Latinoamericano de Nutrición y Salud adult study, an observational multicountry study (N=2,478), were analyzed in 2020. Data were collected between 2014 and 2015. Perceived neighborhood-built environment attributes were measured using the Neighbourhood Environment Walkability Survey. Sedentary time, light-intensity physical activity, and moderate-to-vigorous physical activity data were collected using accelerometers. RESULTS No associations between perceived neighborhood-built environment attributes and sedentary time were found. Positive perceptions of walking/cycling facilities (β=6.50, 95% CI=2.12, 10.39) were associated with more light-intensity physical activity. Perceptions of better aesthetics (Argentina) and better walking/cycling facilities (Brazil and Ecuador) were positively associated with light-intensity physical activity. Land use mix-diversity (β=0.14, 95% CI=0.03, 0.25), walking/cycling facilities (β=0.16, 95% CI=0.05, 0.27), aesthetics (β=0.16, 95% CI=0.02, 0.30), and safety from traffic (β=0.18, 95% CI=0.05, 0.24) were positively associated with moderate-to-vigorous physical activity. Land use mix-diversity, street connectivity, and safety from traffic were positively associated with moderate-to-vigorous physical activity in Venezuela. CONCLUSIONS These findings have implications for policy recommendations, which can guide policies to promote physical activity in the region. Land use mix-diversity, walking/cycling facilities, aesthetics, and safety from traffic can maintain or increase the levels of light-intensity and moderate-to-vigorous physical activity among Latin American adults.
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Affiliation(s)
- Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile.
| | - André O Werneck
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Danilo R Silva
- Department of Physical Education, Federal University of Sergipe - UFS, São Cristóvão, Brazil
| | - Irina Kovalskys
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Lilia Y Cortés
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | - Maria R Liria-Domínguez
- Instituto de Investigación Nutricional, Lima, Peru; Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas, Venezuela
| | - Michael Pratt
- Institute for Public Health, University of California San Diego, San Diego, California
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal; ISAMB, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Ana Carolina B Leme
- Centro de Excelência em Nutrição e Dificuldades Alimentares (CENDA), Instituto Pensi, Hospital Infantil Sabará, São Paulo, Brazil; Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada; Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Mauro Fisberg
- Centro de Excelência em Nutrição e Dificuldades Alimentares (CENDA), Instituto Pensi, Hospital Infantil Sabará, São Paulo, Brazil; Departamento de Pediatria da Universidade Federal de São Paulo, São Paulo, Brazil
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23
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Mendez I, Fasano MV, Guajardo V, Zonis L, Kovalskys I. Dietary Patterns in the Argentinian Population and Their Association With Sociodemographic Characteristics: Results From the ELANS Study (2014–2015). Front Nutr 2022; 9:778390. [PMID: 35356727 PMCID: PMC8959937 DOI: 10.3389/fnut.2022.778390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/25/2022] [Indexed: 11/13/2022] Open
Abstract
AimTo describe dietary patterns in the Argentinian population and their association with sociodemographic characteristics.MethodsCross-sectional analysis of Argentina's food consumption and sociodemographic data of 1,266 men and women between 15 and 65 years from the Latin American Study of Nutrition and Health carried out between March 2014 and December 2015. Dietary patterns were identified by using factor analysis and median factor scores were calculated for gender, age, region, body mass index (BMI), socioeconomic, education, and physical activity categories.ResultsFive dietary patterns were identified. Western, Local Western, and Rural were generally characterized by high consumptions of animal fats, sugar-sweetened beverages, meats or processed meats, pizza and empanadas, sweets, pastries, and low consumption of fruits and vegetables. Traditional pattern was mainly characterized by consumption of oils, starchy vegetables, and red meat and Sweet Prudent by milk and yogurt, vegetables, fruit, artificially sweetened beverages, sweets, and cookies. Higher adherence to the Sweet Prudent pattern was observed in women, in people who meet physical activity guidelines and higher socioeconomic and educational levels. Higher adherence to traditional pattern was only observed for men. Higher adherence to the rest of the patterns was observed mostly by men, young, leaner, lower socioeconomic, and educational levels, not meeting physical activity guidelines, from the metropolitan area of Buenos Aires or northern regions.ConclusionFood consumption in Argentina is expressed in a diversity of dietary patterns. Men, younger, and sedentary individuals, with lower socioeconomic and educational level, from the metropolitan area of Buenos Aires and northern regions, seem to have higher adherence to least healthy dietary patterns.
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Affiliation(s)
- Ignacio Mendez
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP), Hospital de Niños Sor María Ludovica, Buenos Aires, Argentina
- *Correspondence: Ignacio Mendez
| | - Maria Victoria Fasano
- Instituto de Desarrollo e Investigaciones Pediátricas (IDIP), Hospital de Niños Sor María Ludovica, Buenos Aires, Argentina
- Centro de Matemática de La Plata, Facultad de Ciencias Exactas, Universidad Nacional de La Plata/Comisión de Investigaciones Científicas, Buenos Aires, Argentina
| | - Viviana Guajardo
- Instituto para la Cooperación Científica en Ambiente y Salud (ICCAS), Buenos Aires, Argentina
| | - Luciana Zonis
- Instituto para la Cooperación Científica en Ambiente y Salud (ICCAS), Buenos Aires, Argentina
| | - Irina Kovalskys
- Instituto para la Cooperación Científica en Ambiente y Salud (ICCAS), Buenos Aires, Argentina
- Escuela de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
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24
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Ferrari G, Alberico C, Drenowatz C, Kovalskys I, Gómez G, Rigotti A, Cortés LY, García MY, Liria-Domínguez MR, Herrera-Cuenca M, Peralta M, Marques A, Marconcin P, Cristi-Montero C, Leme ACB, Zimberg IZ, Farías-Valenzuela C, Fisberg M, Rollo S. Prevalence and sociodemographic correlates of meeting the Canadian 24-hour movement guidelines among latin american adults: a multi-national cross-sectional study. BMC Public Health 2022; 22:217. [PMID: 35109819 PMCID: PMC8812134 DOI: 10.1186/s12889-022-12613-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/21/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND 24-hour movement behaviors, including moderate-to-vigorous physical activity (MVPA), sedentary time (ST), and sleep duration, have important implications for health across the lifespan. However, no studies exist that have examined the integration of these 24-hour movement behaviors in Latin America. The purpose of this study was to examine the prevalence of meeting the Canadian 24-Hour Movement Guideline recommendations and sociodemographic correlates of meeting the guidelines in adults from eight Latin American countries. METHODS This was a multi-national cross-sectional study of 2338 adults aged 18 to 64 years from the Latin American Study of Nutrition and Health. MVPA and ST data were collected using accelerometers. Sleep duration was self-reported using a daily log. Socio-demographic correlates included sex, age, education level, and marital status. Meeting the 24-hour movement guidelines was defined as: ≥150 min/week of MVPA; ≤8 h/day of ST; and between 7 and 9 h/day of sleep. Logistic regression models were estimated on pooled data. RESULTS The prevalence of adults who met the MVPA, ST, sleep duration, and integrated recommendations was 48.3, 22.0, 19.4, and 1.6%, respectively. Overall, being a woman (OR: 0.72; 95%CI: 0.55,0.93) and having a middle (0.63; 0.47,0.85) or high education level (0.31; 0.17,0.56) was associated with lower odds of meeting all three of the 24-hour movement guideline recommendations. Being married (1.70; 1.25,2.29) was associated with greater odds of meeting all three recommendations. Being a woman (0.46; 0.39,0.55), aged 50-64 years (0.77; 0.60,0.97), and married (0.79; 0.65,0.96) were associated with lower odds of meeting the MVPA recommendation. Having a middle (0.64; 0.50,0.80) or high (0.36; 0.23,0.55) education level was associated with lower odds and being married (1.86; 1.46,2.36) was associated with greater odds of meeting the ST recommendation. Being a woman (0.63; 0.51,0.78) was associated with lower odds; whereas being aged 50-64 years (1.40; 1.04,1.88) and having a middle education level (1.37; 1.09,1.73) were associated with greater odds of meeting the sleep duration recommendation. CONCLUSIONS Overall, the proportion of Latin American adults achieving healthy levels of 24-hour movement behaviors was low. Further efforts are needed to promote more MVPA, less ST, and sufficient sleep in Latin American adults. TRIAL REGISTRATION Clinical Trials NCT02226627 . Retrospectively registered on August 27, 2014.
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Affiliation(s)
- Gerson Ferrari
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Santiago, Chile. .,Laboratorio de Rendimiento Humano, Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile.
| | - Claudia Alberico
- JLC Biomedical and Biotechnology Research Institute (BBRI), North Carolina Central University, 1801 Fayetteville St, 27707, Durham, NC, USA
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020, Linz, Austria
| | - Irina Kovalskys
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Lilia Yadira Cortés
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Martha Yépez García
- Colégio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | - Maria Reyna Liria-Domínguez
- Instituto de Investigación Nutricional, La Molina, Lima, Peru.,Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
| | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES- UCV)/Fundación Bengoa, Caracas, Venezuela
| | - Miguel Peralta
- Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, Lisbon, Portugal.,Faculdade de Medicina, ISAMB, Universidade de Lisboa, Lisbon, Portugal
| | - Adilson Marques
- Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, Lisbon, Portugal.,Faculdade de Medicina, ISAMB, Universidade de Lisboa, Lisbon, Portugal
| | - Priscila Marconcin
- Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, Lisbon, Portugal.,KinesioLab, Research Unit in Human Movement Analysis, Instituto Piaget, Almada, Portugal
| | - Carlos Cristi-Montero
- Physical Education School, IRyS Group, Pontificia Universidad Catolica de Valparaiso, Valparaiso, Chile
| | - Ana Carolina B Leme
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Hospital Infantil Sabará, Instituto Pensi, Fundação José Luiz Egydio Setubal, São Paulo, Brazil
| | - Ioná Zalcman Zimberg
- Departamento de Psicobiologia da Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Mauro Fisberg
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Hospital Infantil Sabará, Instituto Pensi, Fundação José Luiz Egydio Setubal, São Paulo, Brazil.,Departamento de Pediatria da Universidade Federal de São Paulo, São Paulo, Brazil
| | - Scott Rollo
- Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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25
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Energy Imbalance Gap, Anthropometric Measures, Lifestyle, and Sociodemographic Correlates in Latin American Adults-Results from the ELANS Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031129. [PMID: 35162152 PMCID: PMC8835004 DOI: 10.3390/ijerph19031129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 11/16/2022]
Abstract
Overweight and obesity are often explained by an imbalance between energy intake and expenditure. This, in addition to metabolic effects, makes it difficult to assess the real state of individual energy balance. This study aims to analyze the energy gaps between intake and expenditure in the adult population of Latin America, as well as its relationships with sociodemographic variables and nutrition status, to draw an epidemiological perspective based on the trends observed. The energy imbalance gap was used to this end. The difference between energy intake and expenditure can be applied as a reference to explain whether weight equilibrium can prevent weight gain. Moreover, the energy imbalance gap allows for a better understanding of the design of public health policies. Using data from the Latin American Study of Nutrition and Health, the energy imbalance gap in adult population from eight Latin-American countries was assessed in 5994 subjects aged from 19-65. Usual dietary intake was measured using two non-consecutive 24 h dietary recalls. The sociodemographic questionnaire was supplemented by anthropometric measurements. Physical activity was measured through the long International Physical Activity Questionnaire. Energy expenditure was obtained using the basal metabolic rate. For the overall sample, the mean energy intake was 1939.1 kcal (95% CI: 1926.9; 1951.3), the mean of energy expenditure was 1915.7 kcal (95% CI: 1906.4; 1924.9), and the mean of energy imbalance gap was 23.4 kcal (95% CI: 11.9; 35.0). Results show that energy intake and expenditure were higher in men. Moreover, subjects aged 19-34, of high socioeconomic level, who completed high school, were mestizos and were of normal weight consumed the highest number of calories. Overall, a positive energy imbalance gap was observed. Overweight and obese from Argentina, Costa Rica, Ecuador, Peru, and Venezuela showed a significantly lower energy imbalance gap than underweight subjects. These findings confirm the high variability of energy imbalance gap and the accompanying correlates of energy intake and expenditure. Further research is needed to specifically address interventions in low and middle-income countries such as many in Latin America, to help reduce the prevalence of obesity and eradicate undernutrition.
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Gomez-Quiroz LE, Roman S. Influence of genetic and environmental risk factors in the development of hepatocellular carcinoma in Mexico. Ann Hepatol 2022; 27 Suppl 1:100649. [PMID: 34902602 DOI: 10.1016/j.aohep.2021.100649] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 02/06/2023]
Abstract
The latest studies on the epidemiology of diverse types of cancers have located in the scene the relevance of liver tumors, particularly hepatocellular carcinoma (HCC). HCC is a life-threatening malignancy triggered by chronic exposure to hepatitis B and C viruses, excessive alcohol intake, hepatic lipid droplet accumulation, and aflatoxins that lead to persistent liver damage. The occurrence of such etiological risk factors deeply marks the variability in the incidence of HCC worldwide reflected by geography, ethnicity, age, and lifestyle factors influenced by cultural aspects. New perspectives on the primary risk factors and their potential gene-environment interactions (GxE) have been well-addressed in some cancers; however, it continues to be a partially characterized issue in liver malignancies. In this review, the epidemiology of the risk factors for HCC are described enhancing the GxE interactions identified in Mexico, which could mark the risk of this liver malignancy among the population and the measures needed to revert them. Updated healthcare policies focusing on preventive care should be tailored based on the genetic and environmental risk factors, which may influence the effect of the etiological agents of HCC. Robust regional investigations related to epidemiological, clinical, and basic studies are warranted to understand this health problem complying with the rules of ethnic, genetic, environmental, and social diversity.
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Affiliation(s)
- Luis E Gomez-Quiroz
- Área de Medicina Experimental y Traslacional, Departamento de Ciencias de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Mexico City, Mexico
| | - Sonia Roman
- Department of Genomic Medicine in Hepatology, Civil Hospital of Guadalajara, "Fray Antonio Alcalde," Guadalajara, Jalisco, Mexico; Health Sciences Center, University of Guadalajara, Guadalajara, Jalisco, Mexico.
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Alcohol Contribution to Total Energy Intake and Its Association with Nutritional Status and Diet Quality in Eight Latina American Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413130. [PMID: 34948740 PMCID: PMC8701082 DOI: 10.3390/ijerph182413130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/05/2021] [Accepted: 11/05/2021] [Indexed: 12/04/2022]
Abstract
Alcohol consumption is a modifiable risk factor for non-communicable diseases. This study aimed to characterize alcohol consumers at the nutritional, anthropometric, and sociodemographic levels. Data from 9218 participants from Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela participating in “Latin American Health and Nutrition Study (ELANS)”, a multi-country, population-based study, were used. Dietary intake was collected through two, 24 h recalls. Participants were classified into consumers (n = 1073) and non-alcohol consumers (n = 8145) using a cut-off criterium of ≥15 g/day of alcohol consumption calculated from the estimation of their usual daily intake. Among alcohol consumers, the mean alcohol consumption was 69.22 ± 2.18 grams (4.6. beverages/day), contributing to 484.62 kcal, which corresponded to 16.86% of the total energy intake. We found that the risk of alcohol consumption was higher in young and middle-aged men from low and middle socioeconomic status. Argentine, Brazil, and Chile had the highest percentage of consumers, while Ecuador showed the highest alcohol consumption. Alcohol drinkers were characterized by having higher body weight and wider neck, waist, hips circumferences. Alcohol drinkers had a higher energy intake, with macronutrients providing relatively less energy at the expense of the energy derived from alcohol. Alcohol drinkers showed lower and higher consumptions of healthy and unhealthy food groups, respectively. In addition, adequacy ratios for all micronutrients assessed were lower in alcohol consumers. All these deleterious effects of alcohol on nutritional and anthropometric parameters increased with the number of alcoholic beverages consumed daily. Altogether, these findings suggest that limiting alcohol consumption can contribute to reducing the risk of obesity, metabolic syndrome, and diet-related diseases.
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Breakfast in Latin America: Evaluation of Nutrient and Food Group Intake Toward a Nutrient-Based Recommendation. J Acad Nutr Diet 2021; 122:1099-1113.e3. [PMID: 34798337 DOI: 10.1016/j.jand.2021.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 08/29/2021] [Accepted: 11/11/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Little is known about breakfast habits of the Latin American (LA) population to support nutritional recommendations for a balanced breakfast in this region. OBJECTIVE To evaluate the nutritional composition of breakfast in the LA population and to propose recommendations for a balanced breakfast. DESIGN This multicenter cross-sectional study evaluated food and nutrient intake of nationally representative samples of urban populations of 8 LA countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela) in 2014-2015. PARTICIPANTS/SETTING The sample comprised 8714 participants from the Latin American Study of Nutrition and Health, aged 15 to 65 years, randomly recruited according to geographical location, sex, age, and socioeconomic level. MAIN OUTCOME MEASURES Two 24-hour recalls were used to examine dietary intake. Breakfast consumers were stratified by tertiles of Nutrient-Rich Foods Index 9.3 (NRF9.3) to assess the overall diet quality of individuals. Nutrient intake at breakfast of those in the upper tertile of NRF9.3 pooled for the 8 countries was used as a reference for the development of recommendations for LA adolescents and adults. STATISTICAL ANALYSES Comparison of food and nutrient intake of breakfast across NRF9.3 tertiles were analyzed using the Kruskal-Wallis rank sum test. RESULTS Overall breakfast was an important contributor to protein, carbohydrate, and B vitamin intakes but also to added sugar and total and saturated fat intakes relative to daily intakes. Individuals in the upper NRF9.3 tertile had higher intake of key micronutrients such as calcium and potassium at breakfast compared with other tertiles. White breads/rolls/tortillas were the most consumed food group (60%), followed by butter/margarine (40%) and coffee/tea without milk (34%-50%). CONCLUSIONS Breakfast contributed to the daily intake of B vitamins, protein, and carbohydrates but also added sugar and total and saturated fat intakes for all countries. The proposed recommendations support the nutrient density of existing highest-quality breakfast in the LA population while addressing concerns about nutrients to be encouraged or reduced.
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Liria-Domínguez R, Pérez-Albela M, Vásquez MP, Gómez G, Kovalskys I, Fisberg M, Cortés LY, Yépez García MC, Herrera-Cuenca M, Rigotti A, Ferrari G, Pareja RG. Correlation between Neck Circumference and Other Anthropometric Measurements in Eight Latin American Countries. Results from ELANS Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211975. [PMID: 34831736 PMCID: PMC8625507 DOI: 10.3390/ijerph182211975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022]
Abstract
Neck circumference (NC) is being used to identify the risk of chronic diseases. There is a high prevalence of overweight and obesity in Latin America, and neck circumference is a simple and practical measurement to assess this, especially in primary health centers. We analyzed the correlation between the NC anthropometric indicator and other anthropometric measurements such as BMI and waist circumference (WC) in eight Latin American cities. We applied Pearson's correlation to identify the correlate NC with the other anthropometric variables stratified by sex; the sensitivity (Se) and specificity (Sp) by sex were evaluated according to the cut-off established with the Youden Index. The strongest correlations between NC and WC were found when stratified by sex (women: r = 0.71; men: r = 0.69, respectively) followed by the correlation between NC and BMI (r = 0.65, both sex). NC cut-off points of 39.0 cm in men and 32.9 cm in women identified those individuals with an increased WC and 39.8 and 33.7 cm, respectively, for a substantial increase in WC. For BMI ≥ 25.0 kg/m2 for men, the cut-off point was 37.5 cm, and for women, it was 33.1 cm, and for BMI ≥ 30 kg/m2, the cut-off points were 39.2 and 34.2 cm, for men and women, respectively. Conclusion: NC proved to be a useful, practical, and inexpensive tool that can be used to identify, evaluate, and monitor overweight and obese individuals.
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Affiliation(s)
- Reyna Liria-Domínguez
- Instituto de Investigación Nutricional, Lima 15026, Peru;
- Facultad de Ciencias de la Salud, Carrera de Nutrición y Dietética, Universidad Peruana de Ciencias Aplicadas-UPC, Lima 15067, Peru; (M.P.-A.); (M.-P.V.)
- Correspondence: or
| | - Marcela Pérez-Albela
- Facultad de Ciencias de la Salud, Carrera de Nutrición y Dietética, Universidad Peruana de Ciencias Aplicadas-UPC, Lima 15067, Peru; (M.P.-A.); (M.-P.V.)
| | - María-Paz Vásquez
- Facultad de Ciencias de la Salud, Carrera de Nutrición y Dietética, Universidad Peruana de Ciencias Aplicadas-UPC, Lima 15067, Peru; (M.P.-A.); (M.-P.V.)
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José 11501-2060, Costa Rica;
| | - Irina Kovalskys
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires C1107 AAZ, Argentina;
| | - Mauro Fisberg
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil;
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo 04023-061, Brazil
| | - Lilia Yadira Cortés
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
| | | | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas 1053, Venezuela;
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8330024, Chile;
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 7500618, Chile;
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Herrera-Cuenca M, Kovalskys I, Gerardi A, Hernandez P, Sifontes Y, Gómez G, Yépez García MC, Méndez-Pérez B, Landaeta-Jimenez M, Pareja R, Cortés LY, Rigotti A, Fisberg M, Zimberg IZ. Anthropometric Profile of Latin American Population: Results From the ELANS Study. Front Nutr 2021; 8:740361. [PMID: 34820411 PMCID: PMC8606788 DOI: 10.3389/fnut.2021.740361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/05/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Latin America has experienced changes in lifestyle since 1960. Aim: The aim was to determine the prevalence of obesity and stunting among eight countries of Latin American and to identify the determinant risk factors for obesity. Subjects and Methods: Data were obtained from 9,218 participants of the Latin American Study of Nutrition and Health (ELANS), a multicenter cross-sectional study of the representative samples in eight Latin American countries. All the participants completed a standard protocol to investigate the nutrient intake and anthropometric variables (weight, height, and circumferences) analyzed by country, gender, age, and socioeconomic status. Results: The prevalence of obesity was higher in Costa Rica and Venezuela (29%) and lower in Colombia (16%), stunting was reported higher in Peru (47%) and lower in Argentina (17%), and waist and neck circumferences showed the higher values in Costa Rica (43%) and Chile (52%) and lower values in Colombia (23 and 26%). Conclusion: This study indicates an increasing trend toward overweight and obesity that are associated with lower socioeconomic status, being a woman, and concurs with inadequate intakes of calcium, which may be related to poor quality diet and in the long term could constitute risk factors for the chronic diseases and a health burden to the region.
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Affiliation(s)
- Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV), Caracas, Venezuela
- Fundación Bengoa para la Alimentación y Nutrición, Caracas, Venezuela
| | - Irina Kovalskys
- Facultad de Medicina, Pontificia Universidad Católica de Argentina, Buenos Aires, Argentina
| | - Alejandro Gerardi
- Facultad de Medicina, Pontificia Universidad Católica de Argentina, Buenos Aires, Argentina
| | - Pablo Hernandez
- Escuela de Nutrición y Dietética, Universidad Central de Venezuela, Caracas, Venezuela
| | - Yaritza Sifontes
- Fundación Bengoa para la Alimentación y Nutrición, Caracas, Venezuela
- Escuela de Nutrición y Dietética, Universidad Central de Venezuela, Caracas, Venezuela
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | | | - Betty Méndez-Pérez
- Unidad de Investigación en Bioantropología, Actividad Física y Salud, Instituto de Investigaciones Económicas y Sociales Rodolfo Quintero, Universidad Central de Venezuela, Caracas, Venezuela
| | | | | | - Lilia Yadira Cortés
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Mauro Fisberg
- Instituto Pensi, Fundação José Egydio Setubal, Sabará Hospital Infantil, São Paulo, Brazil
- Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Iona Zalcman Zimberg
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Barreno M, Sisa I, Yépez García MC, Shen H, Villar M, Kovalskys I, Fisberg M, Gomez G, Rigotti A, Cortés LY, Pareja RG, Herrera-Cuenca M, Guajardo V. Association between built environment and physical activity in Latin American countries: a multicentre cross-sectional study. BMJ Open 2021; 11:e046271. [PMID: 34732475 PMCID: PMC8572385 DOI: 10.1136/bmjopen-2020-046271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVE To assess the association between the physical activity level and the built environment by accessibility, microinfrastructure and security in Latin America (LA). DESIGN We conducted a multicentre cross-sectional study to collect physical activity and built environment data. The levels of physical activity were calculated through the International Physical Activity Questionnaire survey. Using the Neighbourhood Environment Walkability Scale-Abbreviated, characteristics of the built environment were measured through three domains: accessibility, microinfrastructure and security. To estimate the association of the built environment and physical activity, we used mixed effects logistic regression analysis. In addition, likelihood ratio test to account for clustered effect within countries and/or cities was used. SETTING Eight countries in LA. PARTICIPANTS Adults aged 15-65 years (n=9218) living in urban areas and consented to participate of the Latin American Study of Nutrition and Health. RESULTS Most of the population in LA had access to a grocery store (97.2%), public transport stop (91.5%) and children's playground (81.6%). Metropolitan parks were more accessible in Ecuador (59.8%) and Colombia (59.2%) than in Venezuela (33.5%). Individuals located within 20 min of walking from sport facilities or children's playground areas were more likely to perform moderate-to-high physical activity OR 1.20 (95% CI 1.06 to 1.36) and OR 1.25 (95% CI 1.02 to 1.53), respectively. Only 14.5% of the population from the region considered that their neighbourhood had an adequate design for walking or cycling. Likewise, among adults living in LA, only 39.75% had the perception of living in a safe neighbourhood. CONCLUSIONS This multicentre study shows that currently, LA built environment does not promote physical activity in the region. Our findings provide the rationale to push forward, at regional and national levels, policies and interventions that will help to achieve a safe, healthy and friendly built environment to encourage participation in active recreation and sports in leisure time. TRIAL REGISTRATION NUMBER NCT02226627.
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Affiliation(s)
- Mishell Barreno
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Ivan Sisa
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | | | - Hua Shen
- Department of Mathematics and Statistics, University of Calgary, Calgary, Alberta, Canada
| | - Mónica Villar
- Colegio de Ciencias de la Salud, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Irina Kovalskys
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Mauro Fisberg
- Instituto Pensi, Fundação José Egydio Setubal, Sabará Hospital Infantil, São Paulo, Brazil
- Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Georgina Gomez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Lilia Yadira Cortés
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogota, Colombia
| | | | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas, Venezuela
| | - Viviana Guajardo
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
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Herreros-Irarrázabal D, Guzmán-Habinger J, Mahecha Matsudo S, Kovalskys I, Gómez G, Rigotti A, Cortés LY, Yépez García MC, Pareja RG, Herrera-Cuenca M, Farías-Valenzuela C, Marques A, Leme ACB, Fisberg M, Drenowatz C, Ferrari G. Association between Active Transportation and Public Transport with an Objectively Measured Meeting of Moderate-to-Vigorous Physical Activity and Daily Steps Guidelines in Adults by Sex from Eight Latin American Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11553. [PMID: 34770064 PMCID: PMC8583702 DOI: 10.3390/ijerph182111553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 01/23/2023]
Abstract
This study aimed to examine the associations between active transportation and public transport and the objectively measured meeting of moderate-to-vigorous physical activity (MVPA) and steps per day guidelines in adults by sex from eight Latin American countries. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants aged 18-65 years. MVPA and steps per day were evaluated using Actigraph GT3X accelerometers. The mode of transportation, its frequency and duration were collected using a self-reported questionnaire. The average time dedicated to active transportation was 12.8 min/day in men (IQR: 2.8-30.0) and 12.9 min/day in women (IQR: 4.3-25.7). A logistic regression analysis was conducted, showing that active transportation (≥10 min) was associated with higher odds of meeting MVPA guidelines (men: OR: 2.01; 95%CI: 1.58-2.54; women: OR: 1.57; 95%CI: 1.25-1.96). These results show a greater association when considering active transportation plus public transport (men: OR: 2.98; 95%CI: 2.31-3.91; women: OR: 1.82; 95%CI: 1.45-2.29). Active transportation plus public transport was positively associated with meeting steps per day guidelines only in men (OR: 1.55; 95%CI: 1.15-2.10). This study supports the suggestion that active transportation plus public transport is significantly associated with meeting the MVPA and daily steps recommendations.
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Affiliation(s)
- Diego Herreros-Irarrázabal
- Sports Medicine and Physical Activity Specialty, Science Faculty, Universidad Mayor, Santiago 8580745, Chile; (D.H.-I.); (J.G.-H.); (S.M.M.)
| | - Juan Guzmán-Habinger
- Sports Medicine and Physical Activity Specialty, Science Faculty, Universidad Mayor, Santiago 8580745, Chile; (D.H.-I.); (J.G.-H.); (S.M.M.)
| | - Sandra Mahecha Matsudo
- Sports Medicine and Physical Activity Specialty, Science Faculty, Universidad Mayor, Santiago 8580745, Chile; (D.H.-I.); (J.G.-H.); (S.M.M.)
- Centro de Investigación en Medicina Deporte Ejercicio y Salud—Clínica MEDS, Santiago 7550000, Chile
| | - Irina Kovalskys
- Nutrition Career, Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, Buenos Aires C1107AAZ, Argentina;
| | - Georgina Gómez
- Department of Biochemistry, School of Medicine, Universidad de Costa Rica, San José 11501-2060, Costa Rica;
| | - Attilio Rigotti
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica, Santiago 8330024, Chile;
| | - Lilia Yadira Cortés
- Department of Nutrition and Biochemistry, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
| | | | | | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas 1053, Venezuela;
| | - Claudio Farías-Valenzuela
- Instituto del Deporte, Universidad de las Américas, Santiago 9170022, Chile;
- Department of Didactics of Musical, Plastic and Corporal Expression, Faculty of Education, University of Granada, 18071 Granada, Spain
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisbon, Portugal;
- ISAMB, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Ana Carolina B. Leme
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil; (A.C.B.L.); (M.F.)
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Mauro Fisberg
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil; (A.C.B.L.); (M.F.)
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo 04023-061, Brazil
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020 Linz, Austria;
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 7500618, Chile
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Salvo D, Parra DC, Jáuregui A, Resendiz E, Garcia-Olvera A, Velazquez D, Aguilar-Farias N, Colón-Ramos U, Hino AA, Bill Kohl HW, Pratt M, Varela AR, Ramirez-Zea M, Rivera JA. [Capacidad de investigación en obesidad infantil en Latinoamérica y en las poblaciones latinas de Estados Unidos: estado de la investigación, problemas, oportunidades y líneas de trabajo para el futuro]. Obes Rev 2021; 22 Suppl 5:e13346. [PMID: 34708537 DOI: 10.1111/obr.13346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Deborah Salvo
- Prevention Research Center, Brown School, Washington University in St. Louis, San Luis, Misuri, EE. UU
| | - Diana C Parra
- Prevention Research Center, Brown School, Washington University in St. Louis, San Luis, Misuri, EE. UU
| | - Alejandra Jáuregui
- Departamento de Actividad Física y Estilos de Vida Saludables, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Eugen Resendiz
- Prevention Research Center, Brown School, Washington University in St. Louis, San Luis, Misuri, EE. UU
| | - Armando Garcia-Olvera
- Departamento de Actividad Física y Estilos de Vida Saludables, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Daniel Velazquez
- Departamento de Actividad Física y Estilos de Vida Saludables, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Nicolas Aguilar-Farias
- Departamento de Educación Física, Deportes y Recreación, Grupo de investigación UFRO Actívate, Universidad de la Frontera, Temuco, Chile
| | - Uriyoán Colón-Ramos
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington D.C., EE. UU
| | - Adriano A Hino
- Programa de Pós-Graduação em Tecnologia em Saúde, Pontifícia Universidade Católica do Paraná, Curitiba, Brasil
| | - Harold W Bill Kohl
- School of Public Health in Austin, University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, EE. UU
| | - Michael Pratt
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California, San Diego, California, EE. UU
| | | | - Manuel Ramirez-Zea
- Centro de Investigación del INCAP para la Prevención de las Enfermedades Crónicas, Instituto de Nutrición de Centro América y Panamá, Ciudad de Guatemala, Guatemala
| | - Juan A Rivera
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
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Ferrari G, Guzmán-Habinger J, Chávez JL, Werneck AO, Silva DR, Kovalskys I, Gómez G, Rigotti A, Cortés LY, Yépez García MC, Pareja RG, Herrera-Cuenca M, Drenowatz C, Cristi-Montero C, Marques A, Peralta M, Leme ACB, Fisberg M. Sociodemographic inequities and active transportation in adults from Latin America: an eight-country observational study. Int J Equity Health 2021; 20:190. [PMID: 34446008 PMCID: PMC8390191 DOI: 10.1186/s12939-021-01524-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/29/2021] [Indexed: 01/13/2023] Open
Abstract
Background Active transportation is a crucial sort of physical activity for developing sustainable environments and provides essential health benefits. This is particularly important in Latin American countries because they present the highest burden of non-communicable diseases relative to other worldwide regions. This study aimed to examine the patterns of active transportation and its association with sociodemographic inequities in Latin American countries. Methods This cross-sectional study was conducted in eight countries. Participants (n = 8547, 18–65 years) self-reported their active transportation (walking, cycling, and total) using the International Physical Activity Questionnaire. Sex, age, ethnicity, socioeconomic level, education level, public and private transport use, and transport mode were used as sociodemographic inequities. Results Participants spent a total of 19.9, 3.1, and 23.3 min/day with walking, cycling, and total active transportation, respectively. Mixed and other ethnicity (Asian, Indigenous, Gypsy, and other), high socioeconomic level as well as middle and high education level presented higher walking than Caucasian, low socioeconomic and education level. Private transport mode and use of ≥ 6 days/week of private transport showed lower walking than public transport mode and ≤ 2 days/week of private transport. Use of ≥ 3 days/week of public transport use presented higher walking than ≤ 2 days/week of public transport. Men had higher cycling for active transportation than women. Use of ≥ 3 days/week of public transport use presented higher cycling than ≤ 2 days/week of public transport. ≥6 days/week showed lower cycling than ≤ 2 days/week of private transport use. Men (b: 5.57: 95 %CI: 3.89;7.26), black (3.77: 0.23;7.31), mixed (3.20: 1.39;5.00) and other ethnicity (7.30: 2.55;12.04), had higher total active transportation than women and Caucasian. Private transport mode (-7.03: -11.65;-2.41) and ≥ 6 days/week of private transport use (-4.80: -6.91;-0.31) showed lower total active transportation than public transport mode and ≤ 2 days/week of private transport use. Use of 3–5 (5.10: 1.35;8.85) and ≥ 6 days/week (8.90: 3.07;14.73) of public transport use presented higher total active transportation than ≤ 2 days/week of public transport use. Differences among countries were observed. Conclusions Sociodemographic inequities are associated differently with active transportation across Latin American countries. Interventions and policies that target the promotion of active policies transportation essential to consider sociodemographic inequities. Trial registration ClinicalTrials.Gov NCT02226627. Retrospectively registered on August 27, 2014. Supplementary Information The online version contains supplementary material available at 10.1186/s12939-021-01524-0.
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Affiliation(s)
- Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Las Sophoras 175, Estación Central, Santiago, Chile.
| | - Juan Guzmán-Habinger
- Especialidad medicina del deporte y la actividad física, Facultad de ciencias, Universidad Mayor, Santiago, Chile
| | | | - André O Werneck
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Danilo R Silva
- Department of Physical Education, Federal University of Sergipe - UFS, São Cristóvão, Brazil
| | - Irina Kovalskys
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Lilia Yadira Cortés
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | | | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas, Venezuela
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020, Linz, Austria
| | - Carlos Cristi-Montero
- Physical Education School, IRyS Group, Pontificia Universidad Catolica de Valparaiso, Valparaiso, Chile
| | - Adilson Marques
- Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, 1499-002, Lisbon, Portugal.,Faculdade de Medicina, ISAMB, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - Miguel Peralta
- Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, 1499-002, Lisbon, Portugal.,Faculdade de Medicina, ISAMB, Universidade de Lisboa, 1649-028, Lisbon, Portugal
| | - Ana Carolina B Leme
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA) Instituto Pensi, Hospital Infantil Sabará, Fundação José Luiz Egydio Setubal, São Paulo, Brazil.,Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canada
| | - Mauro Fisberg
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA) Instituto Pensi, Hospital Infantil Sabará, Fundação José Luiz Egydio Setubal, São Paulo, Brazil.,Departamento de Pediatria da Universidade Federal de São Paulo, São Paulo, Brazil
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Socioeconomic Status Impact on Diet Quality and Body Mass Index in Eight Latin American Countries: ELANS Study Results. Nutrients 2021; 13:nu13072404. [PMID: 34371915 PMCID: PMC8308629 DOI: 10.3390/nu13072404] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 12/21/2022] Open
Abstract
Poor health and diet quality are associated with living within a low socioeconomic status (SES). This study aimed to investigate the impact of SES on diet quality and body mass index in Latin America. Data from the "Latin American Health and Nutrition Study (ELANS)", a multi-country, population-based study of 9218 participants, were used. Dietary intake was collected through two 24 h recalls from participants of Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Diet quality was assessed using the dietary quality score (DQS), the dietary diversity score (DDS) and the nutrients adequacy ratio (NAR). Chi-squared and multivariate-variance analyses were used to estimate possible associations. We found that participants from the low SES consumed less fruits, vegetables, whole grains, fiber and fish and seafood and more legumes than those in the high SES. Also, the diet quality level, assessed by DQS, DDS and NAR mean, increased with SES. Women in the low SES also showed a larger prevalence of abdominal obesity and excess weight than those in the middle and high SES. Health policies and behavioral-change strategies should be addressed to reduce the impact of socioeconomic factors on diet quality and body weight, with gender as an additional level of vulnerability.
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Vega-Salas MJ, Caro P, Johnson L, Papadaki A. Socio-economic inequalities in dietary intake in Chile: a systematic review. Public Health Nutr 2021; 25:1-16. [PMID: 34247696 PMCID: PMC9991770 DOI: 10.1017/s1368980021002937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/02/2021] [Accepted: 07/07/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Understanding the socio-economic inequalities in dietary intake is crucial when addressing the socio-economic gradient in obesity rates and non-communicable diseases. We aimed to systematically assess the association between socio-economic position (SEP) and dietary intake in Chile. DESIGN We searched for peer-reviewed and grey literature from inception until 31 December 2019 in PubMed, Scopus, PsycINFO, Web of Sciences and LILACS databases. Observational studies published in English and Spanish, reporting the comparison of at least one dietary factor between at least two groups of different SEP in the general Chilean population, were selected. Two researchers independently conducted data searches, screening and extraction and assessed study quality using an adaptation of the Newcastle Ottawa Quality Assessment Scale. RESULTS Twenty-one articles (from eighteen studies) were included. Study quality was considered low, medium and high for 24, 52 and 24 % of articles, respectively. Moderate-to-large associations indicated lower intake of fruit and vegetables, dairy products and fish/seafood and higher pulses consumption among adults of lower SEP. Variable evidence of association was found for energy intake and macronutrients, in both children and adults. CONCLUSIONS Our findings highlight some socio-economic inequalities in diets in Chile, evidencing an overall less healthy food consumption among the lower SEP groups. New policies to reduce these inequalities should tackle the unequal distribution of factors affecting healthy eating among the lower SEP groups. These findings also provide important insights for developing strategies to reduce dietary inequalities in Chile and other countries that have undergone similar nutritional transitions.
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Affiliation(s)
- María Jesús Vega-Salas
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, BristolBS8 1TZ, UK
| | - Paola Caro
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, BristolBS8 1TZ, UK
| | - Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, 8 Priory Road, BristolBS8 1TZ, UK
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Total and whole grain intake in Latin America: findings from the multicenter cross-sectional Latin American Study of Health and Nutrition (ELANS). Eur J Nutr 2021; 61:489-501. [PMID: 34232375 PMCID: PMC8783851 DOI: 10.1007/s00394-021-02635-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/28/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE Understanding whole-grain intake and its associated factors is essential to tackle the double burden of malnutrition faced by Latin American countries. This study aimed to characterize total and whole grain intake in Latin American countries and to investigate foods contributing to these intake in the region. METHODS Data were obtained from the multicenter cross-sectional survey Latin American Study of Nutrition and Health (ELANS), including 9128 participants residing in urban areas of eight Latin American countries. Data collection was performed via two household visits using a standardized questionnaire and two 24 h dietary recalls. Usual dietary intake of total grain foods and foods containing whole grains was estimated. The association between the intake of grain food groups and sociodemographic variables was investigated using multiple linear regression models with random intercepts. RESULTS Mean intake of total grain foods and foods containing whole grains was 318.6 g/d and 14.7 g/d, respectively. Total grain foods were less consumed by participants at older ages (-9.8 g/d), and females (-9.9 g/d), and more consumed by those in the lowest socioeconomic category (24.8 g/d). Foods containing whole grains were more consumed by participants at older ages (3.3 g/d), and females (4.0 g/d), while those in the lowest socioeconomic category consumed 2.9 g/d less. Major contributors to energy provided from foods containing whole grains were oatmeal, masa harina, whole-wheat bread, corn chips, and wheat crackers. CONCLUSION The intake of grain foods represented a substantial part of the Latin American population's diet, but the intake of foods containing whole grains was extremely low in all assessed countries.
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Aubert S, Brazo-Sayavera J, González SA, Janssen I, Manyanga T, Oyeyemi AL, Picard P, Sherar LB, Turner E, Tremblay MS. Global prevalence of physical activity for children and adolescents; inconsistencies, research gaps, and recommendations: a narrative review. Int J Behav Nutr Phys Act 2021; 18:81. [PMID: 34187486 PMCID: PMC8243483 DOI: 10.1186/s12966-021-01155-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND One of the strategic actions identified in the Global Action Plan on Physical Activity (PA) 2018-2030 is the enhancement of data systems and capabilities at national levels to support regular population surveillance of PA. Although national and international standardized surveillance of PA among children and adolescents has increased in recent years, challenges for the global surveillance of PA persist. The aims of this paper were to: (i) review, compare, and discuss the methodological inconsistencies in children and adolescents' physical activity prevalence estimates from intercontinental physical activity surveillance initiatives; (ii) identify methodological limitations, surveillance and research gaps. METHODS Intercontinental physical activity surveillance initiatives for children and adolescents were identified by experts and through non-systematic literature searches. Prevalence of meeting PA guidelines by country, gender, and age were extracted when available. A tool was created to assess the quality of the included initiatives. Methods and PA prevalence were compared across data/studies and against the methodological/validity/translation differences. RESULTS Eight intercontinental initiatives were identified as meeting the selection criteria. Methods and PA definition inconsistencies across and within included initiatives were observed, resulting in different estimated national prevalence of PA, and initiatives contradicting each other's cross-country comparisons. Three findings were consistent across all eight initiatives: insufficient level of PA of children and adolescents across the world; lower levels of PA among girls; and attenuation of PA levels with age. Resource-limited countries, younger children, children and adolescents not attending school, with disability or chronic conditions, and from rural areas were generally under/not represented. CONCLUSIONS There are substantial inconsistencies across/within included initiatives, resulting in varying estimates of the PA situation of children and adolescents at the global, regional and national levels. The development of a new PA measurement instrument that would be globally accepted and harmonized is a global health priority to help improve the accuracy and reliability of global surveillance.
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Affiliation(s)
- Salomé Aubert
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, Ontario Canada
| | - Javier Brazo-Sayavera
- PDU EFISAL, Centro Universitario Regional Noreste, Universidad de la República, Rivera, Uruguay
- Department of Sports and Computer Science, Universidad Pablo de Olavide (UPO), ES-41013 Seville, Spain
| | - Silvia A. González
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, Ontario Canada
| | - Ian Janssen
- School of Kinesiology and Health Studies, and Department of Public Health Sciences, Queen’s University, Kingston, Ontario Canada
| | - Taru Manyanga
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario Canada
| | - Adewale L. Oyeyemi
- Department of Physiotherapy, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria
| | - Patrick Picard
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, Ontario Canada
| | - Lauren B. Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Evan Turner
- Centre for Global Child Health and SickKids Research Institute, The Hospital for Sick Children, Toronto, Ontario Canada
| | - Mark S. Tremblay
- Healthy Active Living and Obesity Research Group, CHEO Research Institute, Ottawa, Ontario Canada
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Figueroa C, Echeverría G, Villarreal G, Martínez X, Ferreccio C, Rigotti A. Introducing Plant-Based Mediterranean Diet as a Lifestyle Medicine Approach in Latin America: Opportunities Within the Chilean Context. Front Nutr 2021; 8:680452. [PMID: 34249989 PMCID: PMC8266999 DOI: 10.3389/fnut.2021.680452] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/10/2021] [Indexed: 12/11/2022] Open
Abstract
Latin America is experiencing a significant epidemiological and nutritional transition, with a trend toward higher incidence of food-related chronic diseases. In this context, Lifestyle Medicine (LM) is a growing field focused on assisting individuals in adopting healthy behaviors for the prevention and treatment of these chronic diseases, including, among other pillars, a great emphasis on healthy eating. There is also a growing interest worldwide in environmental sustainability of dietary patterns, with increasing concern about their effects on planetary health. In this context, whole-food, plant-based diets -such as the Mediterranean diet (MD)- have emerged as a solution for both healthier eating and lowering environmental impact. Yet in order to be effective at these goals and achieve a high adherence to any nutritional prescription, the sociocultural reality of the community or population where we aim to practice must also be taken into account. In this review, we specifically highlight the plant-based MD as a LM-contextualized dietary pattern that is adaptable, applicable, and sustainable within the Chilean context and has the potential to address the current trend of chronic diseases in our country.
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Affiliation(s)
- Catalina Figueroa
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Guadalupe Echeverría
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Grisell Villarreal
- Magíster en Nutrición, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ximena Martínez
- Magíster en Nutrición, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Catterina Ferreccio
- Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Food intake, physical activity and body composition of adolescents and young adults: data from Brazilian Study of Nutrition and Health. BMC Public Health 2021; 21:1123. [PMID: 34118909 PMCID: PMC8196498 DOI: 10.1186/s12889-021-11171-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lifestyle acquired in youth can determine the individual's health. Constant vigilances in all aspects related to the health of the young population is essential, and evaluate their health parameters is important. The objective of this study was to describe and to compare food intake, physical activity (PA) practice, nutritional status and body composition between adolescents and young adults. METHODS Four hundred seventy-six individuals from the Brazilian Study of Nutrition and Health (EBANS) were analyzed. Food intake was evaluated by applying two 24-h Dietary Recall. The PA and sitting time (ST) were measured by the International Physical Activity Questionnaire in minutes/week and metabolic equivalent task (METs). Body weight and waist circumference (WC) were measured. Body mass index (BMI) and waist circumference to height ratio (WHtR) were calculated. Mann-Whitney and Chi-Square tests were used. RESULTS Energy and macronutrients intake, number of meals, and breakfast skippers weren't different between age groups. 48% of adolescents and 53% of young adults didn't meet the PA recommendation, and adolescents practiced more PA than young adults (total PA: p = 0.006; METs: p < 0.001; leisure PA: p = 0.001); the individuals who studied practiced more PA (total PA: p = 0.034; METs: p = 0.029; leisure PA: p < 0.001) and had ST significantly higher (p = 0.009) than those who worked. Almost 30% of adolescents and 45% of young adults had excess weight; presenting difference according to nutritional status, WC and WHtR (p < 0.001). CONCLUSION There is a high prevalence of excess weight among young Brazilians and differences were observed between age groups regarding nutritional status, body composition and PA practice. TRIAL REGISTRATION ClinicalTrials.Gov NCT02226627 . Retrospectively registered on August 27, 2014.
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Busso D, David A, Penailillo R, Echeverría G, Rigotti A, Kovalskys I, Gómez G, Cortés Sanabria LY, Yépez García MC, Pareja RG, Herrera-Cuenca M, Fisberg M. Intake of Vitamin E and C in Women of Reproductive Age: Results from the Latin American Study of Nutrition and Health (ELANS). Nutrients 2021; 13:1954. [PMID: 34200192 PMCID: PMC8229960 DOI: 10.3390/nu13061954] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/28/2021] [Accepted: 06/02/2021] [Indexed: 12/12/2022] Open
Abstract
Vitamin E was identified as a lipophilic compound essential to maintain rat pregnancy. Low vitamin E intake during early pregnancy associates with congenital malformations and embryonic loss in animals and with miscarriage and intrauterine growth restriction in humans. Vitamin E protects cell membranes from lipoperoxidation and exerts non-antioxidant activities. Its function can be restored by vitamin C; thus, intake and circulating levels of both micronutrients are frequently analyzed together. Although substantial vitamin E inadequacy was reported worldwide, its consumption in Latin America (LatAm) is mostly unknown. Using data from the Latin American Study of Nutrition and Health (Estudio Latinoamericano de Nutrición y Salud, ELANS), we evaluated vitamin E and C intake in women of reproductive age (WRA) from eight LatAm countries and identified their main food sources. Two non-consecutive 24-h dietary recalls in 3704 women aged from 15 to 49 years and living in urban locations showed low average intake of vitamin E (7.9 mg/day vs. estimated average requirement (EAR) of 12 mg/day) and adequate overall vitamin C consumption (95.5 mg/day vs. EAR of 60 mg/day). The mean regional inadequacy was 89.6% for vitamin E and 36.3% for vitamin C. The primary food sources of vitamin E were fats and oils, as well as vegetables. Vitamin C intake was explained mainly by the consumption of fruit juices, fruits, and vegetables. Combined deficient intake of both vitamins was observed in 33.7% of LatAm women. Although the implications of low antioxidant vitamins' consumption in WRA are still unclear, the combined deficient intake of both vitamins observed in one-third of ELANS participants underscores the need for further research on this topic.
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Affiliation(s)
- Dolores Busso
- Biomedical Research and Innovation Center, School of Medicine, Universidad de los Andes, Santiago 7550000, Chile;
| | - Andrea David
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile; (A.D.); (G.E.); (A.R.)
| | - Reyna Penailillo
- Biomedical Research and Innovation Center, School of Medicine, Universidad de los Andes, Santiago 7550000, Chile;
| | - Guadalupe Echeverría
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile; (A.D.); (G.E.); (A.R.)
- Center of Molecular Nutrition and Chronic Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile
| | - Attilio Rigotti
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile; (A.D.); (G.E.); (A.R.)
- Center of Molecular Nutrition and Chronic Diseases, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8320000, Chile
| | - Irina Kovalskys
- Carrera de Nutriciόn, Facultad de Ciencias Médicas, Pontificia Universidad Catόlica Argentina, Buenos Aires C1059ABF, Argentina;
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José 94088, Costa Rica;
| | | | | | | | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV) and Fundación Bengoa, Caracas 1010, Venezuela;
| | - Mauro Fisberg
- Instituto Pensi, Fundação Jose Luiz Egydio Setubal, Hospital Infantil Sabara, São Paulo 04023062, Brazil;
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA) Instituto Pensi, Fundação José Luiz Egydio Setubal, Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo 01239040, Brazil
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Salvo D, Parra DC, Jáuregui A, Reséndiz E, Garcia-Olvera A, Velazquez D, Aguilar-Farias N, Colón-Ramos U, Hino AA, Kohl HWB, Pratt M, Ramirez Varela A, Ramirez-Zea M, Rivera JA. Capacity for childhood obesity research in Latin American and US Latino populations: State of the field, challenges, opportunities, and future directions. Obes Rev 2021; 22 Suppl 3:e13244. [PMID: 33825321 PMCID: PMC8365746 DOI: 10.1111/obr.13244] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/25/2022]
Abstract
Childhood obesity is a major problem in Latin America and among US Latinos. Effective public health policies require contextually relevant evidence to guide them, which demands sustained research capacity. The objectives of this study are to determine research productivity in Latin America and in the United States focused on Latino populations and examine domains of research capacity (research infrastructure, training programs, mentoring, funding, and networks). We conducted a scoping review of indexed childhood obesity-related articles published June 2015-December 2019. We collected data on perceptions of capacity for childhood obesity research among Latin American investigators through an online survey. We identified 612 childhood obesity-related articles (505 from Latin America, 124 from the United States, and 17 US-Latin America collaborations). Brazil, Mexico, Chile, Colombia, and the United States are the top publishing countries. There are similar numbers of obesity, nutrition, and physical activity articles, but physical activity research capacity lagged in other domains (research training, funding, and networking opportunities). Complementary research areas, including sedentary behavior, systems science, and policy studies, are uncommon in Latin America but more prevalent in the United States, whereas sleep research is nascent across settings. Realizing the promise of an effective cross-border collaborative childhood obesity prevention agenda will require committed investment in all domains of research capacity and across all relevant topics.
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Affiliation(s)
- Deborah Salvo
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Diana C Parra
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Alejandra Jáuregui
- Department of Physical Activity and Healthy Lifestyles, Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Eugen Reséndiz
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Armando Garcia-Olvera
- Department of Physical Activity and Healthy Lifestyles, Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Daniel Velazquez
- Department of Physical Activity and Healthy Lifestyles, Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Nicolas Aguilar-Farias
- Department of Physical Education, Sports and Recreation, UFRO Activate Research Group, University of the Frontier, Temuco, Chile
| | - Uriyoán Colón-Ramos
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Adriano A Hino
- Health Technology Graduate Program, Pontifical Catholic University of Parana, Curitiba, Brazil
| | - Harold W Bill Kohl
- School of Public Health in Austin, University of Texas Health Science Center at Houston (UTHealth), Austin, Texas, USA
| | - Michael Pratt
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California, San Diego, California, USA
| | | | - Manuel Ramirez-Zea
- INCAP Research Center for Prevention of Chronic Diseases, Institute of Nutrition of Central America and Panama, Guatemala City, Guatemala
| | - Juan A Rivera
- Center for Research in Nutrition and Health, National Institute of Public Health, Cuernavaca, Mexico
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Ferrari G, Herrera-Cuenca M, Zalcman Zimberg I, Guajardo V, Gómez G, Quesada D, Rigotti A, Yadira Cortés L, Yépez García M, Pareja RG, Peralta M, Marques A, Leme ACB, Kovalskys I, Rollo S, Fisberg M. A Comparison of Associations Between Self-Reported and Device-Based Sedentary Behavior and Obesity Markers in Adults: A Multi-National Cross-Sectional Study. Assessment 2021; 29:1441-1457. [PMID: 34044597 DOI: 10.1177/10731911211017637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to examine the associations between self-reported and device-based measures of sedentary behavior (SB) with obesity markers in adults from Latin American countries. Sitting time and total time spent in different SBs were self-reported using two different questionnaires. Accelerometers were used to assess total sedentary time. Body mass index, waist, and neck circumferences were assessed. The highest self-reported sitting time was in Argentina, the highest total time spent in different SBs was in Brazil and Costa Rica, and the highest device-based sedentary time was observed in Peru. Neither self-reported sitting time, total time spent in different SBs or device-based sedentary time were associated with body mass index. Device-based sedentary time was positively associated with waist circumference and self-reported sitting time was positively associated with neck circumference. Caution is warranted when comparing the associations of self-reported and device-based assessments of SB with anthropometric variables.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Ana Carolina B Leme
- University of Guelph, Guelph, Canada.,Instituto PENSI - Sabara Hospital Infantil, São Paulo, Brazil
| | - Irina Kovalskys
- Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Scott Rollo
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada
| | - Mauro Fisberg
- Universidade Federal de São Paulo, São Paulo, Brazil.,Instituto PENSI - Sabara Hospital Infantil, São Paulo, Brazil
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B. Leme AC, Ferrari G, Fisberg RM, Kovalskys I, Gómez G, Cortes LY, Yépez Gárcia MC, Herrera-Cuenca M, Rigotti A, Liria-Domínguez MR, Fisberg M. Co-Occurrence and Clustering of Sedentary Behaviors, Diet, Sugar-Sweetened Beverages, and Alcohol Intake among Adolescents and Adults: The Latin American Nutrition and Health Study (ELANS). Nutrients 2021; 13:nu13061809. [PMID: 34073533 PMCID: PMC8228398 DOI: 10.3390/nu13061809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 12/12/2022] Open
Abstract
Poor diet, sedentary behaviors, sugar-sweetened beverages (SSB) and alcohol intake seem to co-exist in complex ways that are not well understood. The aim of this study was to provide an understanding of the extent to which unhealthy behaviors cluster in eight Latin America countries. A secondary aim was to identify socio-demographic characteristics associated with these behaviors by country. Data from adolescents and adults from the “Latin American Health and Nutrition Study” was used and the prevalence of screen-time, occupational and transportation–sedentary time, socializing with friends, poor diet, SSB and alcohol intake, alone and in combination, were identified. The eight Latin America (LA) countries added to analyses were: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela. Logistic regression was used to estimate associations between ≥2 behaviors clustering, socio-demographics and weight status. Among 9218 individuals, the most prevalent behaviors were transportation and occupation–sedentary time, SSB and alcohol intake. Younger, female, married/living with a partner, low and middle-income and obese individuals had higher chances for these clustering behaviors. These results provide a multi-country level of understanding of the extent to which behaviors co-occur in the LA population.
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Affiliation(s)
- Ana Carolina B. Leme
- Center for Excellence in Nutrition and Feeding Difficulties, PENSI Institute, Sabará Children’s Hospital, São Paulo 05076-040, Brazil;
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada
- Correspondence:
| | - Gerson Ferrari
- Escuela de Ciências de la Actividad Fisica, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 7500618, Chile;
| | - Regina M. Fisberg
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 05508-060, Brazil;
| | - Irina Kovalskys
- Faculty of Medicine, Pontifical Catholic University from Argentina, Buenos Aires C1107AAZ, Argentina;
| | - Georgina Gómez
- Department of Biochemistry, School of Medicine, University of Costa Rica, San José 11501-2060, Costa Rica;
| | - Lilia Yadira Cortes
- Department of Nutrition and Biochemistry, Pontifical University Catholic from Javeriana, Bogota 111321, Colombia;
| | | | - Marianella Herrera-Cuenca
- Center of Developmental Studies, Central University of Venezuela (CENDES-UCV)/Bengoa Foundation, Caracas 47604, Venezuela;
| | - Attilo Rigotti
- Center of Molecular Nutrition and Chronic Diseases, Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontifical Catholic University from Chile, Santiago 833115, Chile;
| | - María Reyna Liria-Domínguez
- Investigacíon Nutricional, La Molina, Lima 15024, Peru;
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciências Aplicadas, Lima 15023, Peru
| | - Mauro Fisberg
- Center for Excellence in Nutrition and Feeding Difficulties, PENSI Institute, Sabará Children’s Hospital, São Paulo 05076-040, Brazil;
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Food Sources of Shortfall Nutrients among Latin Americans: Results from the Latin American Study of Health and Nutrition (ELANS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094967. [PMID: 34067018 PMCID: PMC8125540 DOI: 10.3390/ijerph18094967] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 01/21/2023]
Abstract
Increased consumption of energy-dense, nutrient-poor foods can lead to inadequate intakes of shortfall nutrients, including vitamin A, D, C, and E, dietary folate, calcium, iron, magnesium, potassium, and fiber. The objective was to examine the prevalence of inadequate intake of shortfall nutrients and identify food sources of shortfall nutrients in eight Latin American countries. Data from ELANS, a multi-country, population-based study of 9218 adolescents and adults were used. Dietary intake was collected through two 24 h Recalls from participants living in urban areas of Argentina, Brazil, Chile, Colombia, Ecuador, Peru, and Venezuela. Foods and beverages were classified using the adapted version of the NHANES "What We Eat in America" system. Nutrients inadequacy was estimated using the Institute of Medicine recommendations and descriptive statistics were calculated. Prevalence of inadequacy was above 50% for most of the nutrients, which the exception of vitamin C with a prevalence of inadequacy of 39%. Milk, cheese, seafoods, breads, and fruit juices/drinks were among the top 5 sources for each of the 10 shortfall nutrients examined. Many food categories were top contributors to more than one dietary component examined. Understanding the nutrient intake and food sources can help inform dietary guidance and intervention approaches.
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Ferrari G, Marques A, Barreira TV, Kovalskys I, Gómez G, Rigotti A, Cortés LY, García MCY, Pareja RG, Herrera-Cuenca M, Guajardo V, Leme ACB, Guzmán Habinger J, Valdivia-Moral P, Suárez-Reyes M, Ihle A, Gouveia ER, Fisberg M. Accelerometer-Measured Daily Step Counts and Adiposity Indicators among Latin American Adults: A Multi-Country Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094641. [PMID: 33925513 PMCID: PMC8123766 DOI: 10.3390/ijerph18094641] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 12/14/2022]
Abstract
The aim of the present study was to examine the sex-related associations between accelerometer-measured daily step counts and adiposity indicators in adults from eight Latin American countries. We analyzed data from 2524 adults (aged 18–65 years) from the Latin American Study of Nutrition and Health. Device-measured daily step counts were measured by accelerometers (ActiGraph GT3X). The outcomes were body mass index (BMI; (kg/m2), waist and neck circumference (in cm). Overall, the mean of daily steps counts, BMI, waist and neck circumference were 10699.8, 27.3, 89.6, and 35.8. Weak and negative associations were observed between daily steps counts and BMI (r = −0.17; p < 0.05) and waist circumference (r = −0.16; p < 0.05); however, step counts was not associated with neck circumference. Daily steps counts were negatively associated with BMI (β: −0.054; 95%CI: −0.077; −0.012) and waist circumference (−0.098; −0.165; −0.030) independently of age and socioeconomic level. In men, there were significant negative associations between daily steps counts with BMI (−0.075; −0.119; −0.031) and waist circumference (−0.140; −0.233; −0.048), and in women, there was no significant association with either of the body composition indicators. The findings from this study need to be examined in prospective settings that use device-measured from Latin America.
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Affiliation(s)
- Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 7500618, Chile; (G.F.); (M.S.-R.)
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisbon, Portugal;
- ISAMB, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Tiago V. Barreira
- Department of Exercise Science, School of Education, University of Syracuse, Syracuse, NY 13210, USA;
| | - Irina Kovalskys
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires C1107AAZ, Argentina;
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José 11501-2060, Costa Rica;
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago 8330024, Chile;
| | - Lilia Yadira Cortés
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
| | | | | | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas 1053, Venezuela;
| | - Viviana Guajardo
- Nutrition, Health and Wellbeing Area, International Life Science Institute (ILSI) Argentina, Santa Fe Av. 1145, Caba C1059ABF, Argentina;
| | - Ana Carolina B. Leme
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil; (A.C.B.L.); (M.F.)
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Juan Guzmán Habinger
- Sports Medicine and Physical Activity Specialty, Science Faculty, Universidad Mayor, Santiago 8580745, Chile;
| | - Pedro Valdivia-Moral
- Faculty of Science Education, Campus de Cartuja, University of Granada, 18071 Granada, Spain
- Correspondence: ; Tel.: +34-958242829
| | - Mónica Suárez-Reyes
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 7500618, Chile; (G.F.); (M.S.-R.)
| | - Andreas Ihle
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland;
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, Lausanne and Geneva, 1022 Chavannes-près-Renens, Switzerland
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland
| | - Elvio R. Gouveia
- Departamento de Educação Física e Desporto, Universidade da Madeira, 9020-105 Funchal, Portugal;
- Interactive Technologies Institute, LARSyS, 9020-105 Funchal, Portugal
| | - Mauro Fisberg
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil; (A.C.B.L.); (M.F.)
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo 04023-061, Brazil
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Contribution of food groups to energy, grams and nutrients-to-limit: the Latin American Study of Nutrition and Health/Estudio Latino Americano de Nutrición y Salud (ELANS). Public Health Nutr 2021; 24:2424-2436. [PMID: 33843560 DOI: 10.1017/s136898002100152x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To quantify the energy, nutrients-to-limit and total gram amount consumed and identify their top food sources consumed by Latin Americans. DESIGN Data from the Latin American Study of Nutrition and Health (ELANS). SETTING ELANS is a cross-sectional study representative of eight Latin American countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. PARTICIPANTS Two 24-h dietary recalls on non-consecutive days were used to estimate usual dietary intake of 9218 participants with ages between 15-65 years. 'What We Eat in America' food classification system developed by United States Department of Agriculture was adapted and used to classify all food items consumed by the ELANS population. Food sources of energy, added sugars, SFA, Na and total gram amount consumed were identified and ranked based on percentage of contribution to intake of total amount. RESULTS Three-highest ranked food categories of total energy consumed were: rice (10·3%), yeast breads (6·9%), and turnovers and other grain-based items (6·8 %). Highest ranked food sources of total gram amount consumed were fruit drinks (9·6%), other 100% juice (9·3%) and rice (8·3%). Three highest ranked sources for added sugars were other 100% juice (24·1 %), fruit drinks (16·5%), and sugar and honey (12·4%). SFA ranked foods were turnovers and other grain-based (12·6 %), cheese (11·9%), and pizza (10·3%). Three top sources of Na were rice (13·9%), soups (9·1 %) and rice mixed dishes (7·3 %). CONCLUSION Identification of top sources of energy and nutrients-to-limit among Latin Americans is critical for designing strategies to help them meet nutrient recommendations within energy needs.
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48
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Ferrari G, Werneck AO, Silva DR, Kovalskys I, Gómez G, Rigotti A, Cortés LY, García MY, Liria M, Herrera-Cuenca M, Zimberg IZ, Guajardo V, Pratt M, Cristi-Montero C, Marques A, Peralta M, Bolados CC, Leme ACB, Rollo S, Fisberg M. Agreement Between Self-Reported and Device-Based Sedentary Time among Eight Countries: Findings from the ELANS. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:1036-1047. [PMID: 33502675 DOI: 10.1007/s11121-021-01206-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to analyze the agreement between self-reported and device-based sedentary time among eight countries in Latin America. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants (18-65 years) across eight countries. Participants reported time spent sedentary in different activities (computer use at home, videogame use, reading, sitting down to chat with friends/relatives or listening to music, speaking on the phone, watching TV, and riding in a car). Overall sitting time was assessed using a single item from the International Physical Activity Questionnaire (IPAQ). Device-based sedentary time was assessed using Actigraph GT3X accelerometers. Self-reported overall sitting time (227.1 min/day) produced the lowest values of the three assessment methods, followed by self-reported sum of different types of sedentary behavior (364.1 min/day) and device-based sedentary time (568.6 min/day). Overall, correlation coefficients and ICC varied from weak to moderate (rho: 0.25-0.39; ICC: 0.21:0.39) between self-reported sum of different types of sedentary behavior, self-reported overall sitting time, and device-based sedentary time. The Bland-Altman plots indicated low to moderate agreement between self-reported overall sitting time and device-based sedentary time by sex. Self-report measures underestimate sedentary behavior and overall sitting time when compared with device-based measures. The weak and moderate level of agreement between methods indicates that caution is required when comparing associations between different self-report and device-based measures of sedentary behavior with health outcomes.
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Affiliation(s)
- Gerson Ferrari
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Las Sophoras 175, Estación Central, Santiago, Chile.
| | - André O Werneck
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Danilo R Silva
- Department of Physical Education, Federal University of Sergipe - UFS, São Cristóvão, Brazil
| | - Irina Kovalskys
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Georgina Gómez
- Departamento de Bioquímica, Escuela de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Attilio Rigotti
- Centro de Nutrición Molecular y Enfermedades Crónicas, Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica, Santiago, Chile
| | - Lilia Yadira Cortés
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Martha Yépez García
- Colégio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, Ecuador
| | - María Liria
- Instituto de Investigación Nutricional, La Molina, Lima, Peru
| | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas, Venezuela
| | - Ioná Zalcman Zimberg
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Viviana Guajardo
- Carrera de Nutrición, Facultad de Ciencias Médicas, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Michael Pratt
- Institute for Public Health, University of California San Diego, La Jolla, CA, USA
| | - Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Adilson Marques
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,ISAMB, University of Lisbon, Lisbon, Portugal
| | - Miguel Peralta
- CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.,ISAMB, University of Lisbon, Lisbon, Portugal
| | - Cristian Cofre Bolados
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Las Sophoras 175, Estación Central, Santiago, Chile
| | - Ana Carolina B Leme
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, Brazil.,Family Relations and Applied Nutrition, University of Guelph, Guelph, Canada.,Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo, Brazil
| | - Scott Rollo
- Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Mauro Fisberg
- Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo, Brazil.,Departamento de Pediatria da Universidade Federal de São Paulo, São Paulo, Brazil
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Espinoza López PA, Fernández Landeo KJ, Pérez Silva Mercado RR, Quiñones Ardela JJ, Carrillo-Larco RM. Neck circumference in Latin America and the Caribbean: A systematic review and meta-analysis. Wellcome Open Res 2021; 6:13. [PMID: 33954266 PMCID: PMC8080980 DOI: 10.12688/wellcomeopenres.16560.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background: High neck circumference (NC) is associated with high burden diseases in Latin American and the Caribbean (LAC). NC complements established anthropometric measurements for early identification of cardio-metabolic and other illnesses. However, evidence about NC has not been systematically studied in LAC. We aimed to estimate the mean NC and the prevalence of high NC in LAC. Methods: We conducted a systematic review in MEDLINE, Embase, Global Health and LILACS. Search results were screened and studied by two reviewers independently. To assess risk of bias of individual studies, we used the Hoy
et al. scale and the Newcastle-Ottawa scale. We conducted a random-effects meta-analysis. Results: In total, 182 abstracts were screened, 96 manuscripts were reviewed and 85 studies (n= 51,978) were summarized. From all the summarized studies, 14 were conducted in a sample of the general population, 23 were conducted with captive populations and 49 studies were conducted with patients. The pooled mean NC in the general population was 35.69 cm (95% IC: 34.85cm-36.53cm; I²: 99.6%). In our patient populations, the pooled mean NC in the obesity group was 42.56cm (95% CI 41.70cm-43.42cm; I²: 92.40%). Across all studied populations, there were several definitions of high NC; thus, prevalence estimates were not comparable. The prevalence of high NC ranged between 37.00% and 57.69% in the general population. The methodology to measure NC was not consistently reported. Conclusions: Mean NC in LAC appears to be in the range of estimates from other world regions. Inconsistent methods and definitions hamper cross-country comparisons and time trend analyses. There is a need for consistent and comparable definitions of NC so that it can be incorporated as a standard anthropometric indicator in surveys and epidemiological studies.
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Affiliation(s)
| | | | | | | | - Rodrigo M Carrillo-Larco
- Department of Epidemiology and Biostatistics London, School of Public Health, Imperial College London, London, UK.,CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
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50
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[Poverty as a determinant of food quality in Argentina. Results of the Argentine Study of Nutrition and Health (EANS)]. NUTR HOSP 2021; 37:114-122. [PMID: 31960690 DOI: 10.20960/nh.02828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introduction: socio-economic differences lead to food and nutritional inequalities. Diet is a modifiable risk factor by public health activities, on the way to the prevention of chronic non-communicable diseases. Objective: to estimate food inequalities in Argentina based on the socioeconomic level of the population, analyzing the consumption of different food groups. Methods: Argentine data from the Latin American Study of Nutrition and Health. Sample: 1,266 individuals stratified by gender, socioeconomic level and geographic region. Intake: 2 24-hour reminders with the multi-step technique. Analysis: with the NDS Software average consumption values of 11 food groups were analyzed by socioeconomic level and country region. Results: the population with lower socioeconomic status consumes significantly less fruits, vegetables and dairy products than the population with medium to high socioeconomic level. Fruits: 59 vs. 79.1 and 106.3 g/d, respectively; p = 0.000. Vegetables: 82.3 g/d vs. 112 and 118 g/d; p = 0.000. Dairy products: 114 g/d vs. 165 and 137 g/d; p = 0.000). On the contrary, it consumes a greater volume of soft drinks and industrial juices (680 mL/d vs. 527 and 590 mL/d, respectively; p = 0.000), infusions with added sugar (568 mL/d vs. 385 and 309 mL/d; p = 0.000), bread (85 g/d vs. 75.5 and 66.7 g/d; p = 0.012) and pastries (159 g/d vs. 147 and 122 g/d; p = 0.008). Conclusions: Social vulnerability is an important determinant for diet quality. Interventions designed to reduce social inequalities as linked to nutrition and health are essential.
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